摘要
目的探讨采用叶酸受体探针标记的方法检测循环肿瘤细胞(CTCs)在预测尿路上皮癌淋巴结转移中的应用价值。方法回顾性分析北京大学肿瘤医院2017年9月至2019年9月接受CTCs检测的96例尿路上皮癌患者的临床和病理资料。男74例,女22例。年龄40~87岁,平均62岁。上尿路肿瘤(肾盂癌、输尿管癌)13例,膀胱癌83例。12例存在淋巴结转移。初发病例77例,复发病例19例。单病灶组68例,多病灶组28例。肿瘤T分期:Ta期(非浸润性)29例,T1期(浸润固有层)42例,T2期(浸润肌层)16例,≥T3期(肌层外侵犯)9例。采集患者禁食≥8 h后的外周血3 ml,裂解、离心后加入免疫磁珠,再加入叶酸探针标记,最后进行扩增,计算每毫升血液中CTCs拷贝数值(CNC)。分析CTCs表达情况与病理结局的关系,采用logistic线性回归进行单因素和多因素分析发生淋巴结转移的危险因素。结果所有患者CNC为12.3±7.3。≤62岁组CNC为10.8±4.2,>62岁组为13.7±9.2;初发病例CNC为11.5±5.3,复发病例为15.5±12.2;年龄(P=0.135)及发病次数(P=0.087)对CNC没有影响。病灶单发组CNC为10.5±5.2,多发组为16.5±9.7;Ta期CNC为8.2±2.3,T1期为12.0±4.4,T2期为16.4±6.8,≥T3期为19.5±16.6;病灶数(P<0.001)和病理T分期(P<0.001)与CNC有显著相关性。单因素回归分析结果显示,T分期(P<0.001)、CNC(P=0.02)与淋巴结转移相关;多因素分析结果显示仅T分期可以作为淋巴结转移的独立预测因素(P=0.002)。结论CTCs检测可以用于预测尿路上皮癌淋巴结转移。采用叶酸受体探针标记的CTCs可以用于尿路上皮癌的临床研究。
Objective To discuss the application experience and predictive value of circulating tumor cells for urothelial carcinoma.Methods The clinical data of 96 patients with urothelial carcinoma treated by Beijing Cancer Hospital Urologic Department between September 2017 and September 2019 were analyzed retrospectively to evaluate relationship between the number of CTCs and pathological outcome.The mean age of the entire cohort was 62(40-87)years,with 74 males and 22 females.There were 13 cases of upper urinary tract tumors(pyelocarcinoma and ureteral carcinoma),83 cases of bladder carcinoma,and 12 cases of lymph node metastasis.There were 77 cases of primary onset and 19 cases of recurrence.68 cases in single focus group and 28 cases in multiple group.There were 29 cases in non infiltrative Ta stage,42 cases in infiltrative lamina propria T1 stage,16 cases in infiltrative muscle T2 stage,and 9 cases in extra-muscular≥T3 stage.At least 3ml of peripheral blood was collected after fasting for at least 8 hours,After cleavage and centrifugation,immunomagnetic beads were added,folate probe was added,and then amplification was carried out.Then the copy number of CTCs in each ml of blood was calculated.Logistic linear regression was used to analyze the risk factors of lymph node metastasis.Results The mean CNC of all patients was 12.3±7.3;the mean CNC of≤62 years old group was 10.8±4.2;the mean CNC of>62 years old group was 13.7±9.2;the mean CNC of initial cases was 11.5±5.3;the mean CNC of recurrent cases was 15.5±12.2.Age(P=0.135)and frequency of onset(P=0.087)had no effect on the number of CTCs.The average CNC of single focus group was 10.5±5.2,multiple focus group was 16.5±9.7,Ta stage group was 8.2±2.3,T1 stage group was 12.0±4.4,T2 stage group was 16.4±6.8,and≥T3 stage group was 19.5±16.6.The number of lesions(P<0.001)was significantly correlated with pathological T stage(P<0.001)and the number of CTCs.Univariate regression analysis showed that T stage(P<0.001)and the number of CTCs(P=0.02)might be correlated with lymph node metastasis;multivariate analysis showed that only T stage could be used as an independent predictor of lymph node metastasis(P=0.002).Conclusions CTCs can be used to predict lymph node metastasis of urothelial carcinoma.
作者
刘佳
曹煜东
汤星星
王硕
杨勇
张宁
杜鹏
Liu Jia;Cao Yudong;Tang Xingxing;Wang Shuo;Yang Yong;Zhang Ning;Du Peng(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Department of Urological Surgery,Peking University Cancer Hospital and Institute,Beijing 100142,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2019年第12期885-888,共4页
Chinese Journal of Urology
关键词
癌
移行细胞
尿路上皮癌
膀胱癌
循环肿瘤细胞
淋巴结转移
危险因素
Carcinoma
transitional cell
Urothelial carcinoma
Bladder cancer
Circulating tumor cells(CTCs)
Lymph node metastasis
Risk factor
