| 方法状,陆晓珑,方建明,陈献琦,刘艳省,张家敏.间质表型CTC检测在肝癌临床应用价值探索[J].浙江中西医结合杂志,2021,31(5): |
| 间质表型CTC检测在肝癌临床应用价值探索 |
| Mesenchymal Phenotypic Circulating Tumor Cell Enrichment and Detection to Assist the Clinical Diagnosis of Hepatocellular carcinoma |
| 投稿时间：2020-12-16 修订日期：2021-04-03 |
| DOI： |
| 中文关键词: 肝细胞肝癌 循环肿瘤细胞 CTC 间质表型 CytoSorter |
| 英文关键词:hepatocellular carcinoma circulating tumor cells CTC mesenchymal CytoSorter |
| 基金项目:金华市科学技术局重点项目 肝细胞癌根治术后不同时段CTC分布与预后相关性的临床研究 |
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| 中文摘要: |
| 目的 探索间质表型循环肿瘤细胞（Mesenchymal Circulating Tumor Cell, MCTC）与肝癌患者临床病理特征相关性，及辅助肝癌患者临床诊断价值。方法 我院2019年3月到2020年9月期间48例初诊疑似肝癌患者，经病理学检查确诊35例初诊Ia期~IIIb期肝细胞肝癌和13例良性肝病患者，以及13例健康人作为阴性对照，使用CytoSorter? CTC检测系统结合CSV捕获抗体，特异性富集检测肝癌患者外周血MCTC。结果 CytoSorter? CTC检测系统对初诊肝癌患者外周血MCTC检测敏感性为82.86%（29/35），特异性为84.62%（22/26）。13例健康人和13例良性肝病患者外周血MCTC检出个数均小于2个/5mL。肝癌患者外周血MCTC检出数量明显高于健康人和良性肝病患者，且差异极显著，具有统计学意义（P＜0.0001）。治疗前MCTC水平与患者AFP水平、HbsAg状态、肿瘤数量、CNLC分期、血管侵犯、淋巴结转移和肿瘤远端转移具有显著相关性；治疗前MCTC数量与治疗后MCTC数量存在显著差异（P＜0.001），治疗后MCTC数量普遍下降减少，临床疗效评估结果显示大部分患者疾病得到缓解。结论 CytoSorter? CTC检测系统在肝癌患者外周血MCTC富集检测中具有较好的检出效率，实时动态监测肝癌患者外周血MCTC可以辅助肝癌患者早期诊断、疗效评估和复发转移监测。 |
| 英文摘要: |
| Objective To explore the correlation between mesenchymal phenotype circulating tumor cells (MCTC) and the clinicopathological characteristics of hepatocellular carcinoma (HCC), and the clinical diagnostic significance and diagnostic value . Methods From March 2019 to September 2020 , there were 48 newly diagnosed patients with suspected HCC, 35 newly diagnosed stage Ia~IIIb HCC and 13 patients with benign liver disease were diagnosed by pathological examination. 13 healthy people were regarded as negative in contrast, CytoSorter? CTC detection system combined with CSV capture antibody was used to specifically enrich and detect MCTC in peripheral blood of patients with HCC. Analyze the correlation between MCTC and the clinicopathological characteristics of HCC, compare the differences between MCTC in HCC patients, benign liver disease patients and healthy people, and the relationship between HCC metastasis. Through the number of MCTC and the change of the number of MCTC before and after treatment, the clinical diagnostic value of MCTC-assisted treatment of HCC patients with prognosis evaluation, curative effect monitoring, and recurrence and metastasis monitoring are explored. Results CytoSorter? CTC detection system has a sensitivity of 82.86% (29/35) and a specificity of 84.62% (22/26) for the detection of peripheral blood MCTC in newly diagnosed HCC patients. The number of MCTCs detected in peripheral blood of 13 healthy people and 13 patients with benign liver disease was less than 2/5mL. The number of MCTCs detected in peripheral blood of HCC patients was significantly higher than that of normal people and patients with benign liver disease, and the difference was extremely significant and statistically significant (P<0.0001). Before treatment, the MCTC level was related to the patient’s AFP level , HbsAg status, number of tumors, CNLC stage, vascular invasion , lymph node metastasis and distant metastasis has a significant correlation; There was a significant difference between the number of MCTCs before treatment and after treatment (P＜0.001). After treatment, the number of MCTCs generally decreased, and the clinical efficacy evaluation results showed that most patients' diseases were relieved. Conclusion The CytoSorter? CTC detection system has a good detection efficiency in the detection of peripheral blood MCTC enrichment in HCC patients. Real-time dynamic monitoring of peripheral blood MCTC in HCC patients can assist in early diagnosis, curative effect evaluation, prognostic evaluation and recurrence and metastasis monitoring. |
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