摘要
目的 探讨循环肿瘤细胞(CTC)计数对肾细胞癌(RCC)不同手术方式的选择、对各临床特征及其预后的应用价值。方法 选取2018年10月至2021年4月承德医学院附属医院泌尿外科收治的73例RCC患者。所有患者均通过术后病理确诊。术前1周及术后1周检测CTC,根据CTC计数(5个/3.5 m L)分为CTC阳性组39例和CTC阴性组34例。通过逻辑回归进行分析,以比较2种不同术式CTC数量的变化、比较肿瘤大小、血尿情况、临床分期(TNM)、病理分级、组织类型、循环内皮细胞(CEC)、循环肿瘤细胞聚集体(CTC Cluste)、基因突变、转移及预后情况。对2组患者进行36个月的随访,终点事件为肿瘤复发转移。结果 2组患者一般资料差异无统计学意义(P>0.05)。阳性组中,无论开放还是微创手术,术后CTC数量均降低,但开放手术术后减低差异有统计学意义(P<0.05)。阴性组中,无论开放还是微创术后CTC数量均升高,且微创术后的CTC升高明显(P<0.05)。2组在肿瘤大小、CEC、基因突变、TNM差异有统计学意义(P<0.05)。肿瘤大小和CEC是影响CTC水平的主要因素(P<0.05)。结论 肿瘤大小和CEC是影响RCC CTC的主要危险因素。CTC的数目可作为手术方式选择的潜在指标具有潜在价值,同时可作为较好的术后复发转移监测指标。
Objective To investigate the value of circulating tumor cell(CTC)count in the selection of different surgical methods,clinical features and prognosis of renal cell carcinoma(RCC).Methods Seventy-three RCC patients admitted to the Department of Urology of the Affiliated Hospital of Chengde Medical University from October 2018 to April 2021 were selected.All patients were confirmed by postoperative pathology.CTC count was detected 1 week before surgery and 1 week after surgery.Based on this finding,patients were divided into CTC-positive group(n=39)and CTC-negative group(n=34)according to the number of CTCS(5/3.5 mL).We performed logistic regression analysis to compare changes in the number of CTCS between the two different procedures,tumor size,hematuria,TNM(clinical stage),pathological grade,tissue type,CEC(circulating endothelial cells),CTC cluste(aggregates),gene mutation,metastasis,and prognosis.Patients in both groups were followed up for 36 months,and the endpoint events were tumor recurrence and metastasis.Results There were no difference in the general data between the two groups.In the CTC-positive group,the number of CTC decreased after both open and minimally invasive surgery,but there was a significant difference in the reduction after an open surgery(P<0.05).In the CTC-negative group,the number of CTC increased both after open and minimally invasive surgery,and the increase in CTC after a minimally invasive surgery was significant(P<0.05).There were significant differences in tumor size,CEC,gene mutation,and TNM staging between the two groups(P<0.05).Tumor size and CEC were the main factors affecting CTC count(P<0.05).Conclusion Tumor size and CEC are the main risk factors for RCC and CTC.CTC count can be used as a potential indicator of surgical choice,serving as a better indicator to monitor postoperative recurrence and metastasis.
作者
宋殿宾
王志勇
张晶晶
李修明
迟强
徐辉
李红阳
刘英
SONG Dianbin;WANG Zhiyong;ZHANG Jingjing(Department of Urology,Affiliated Hospital of Chengde Medical University,Hebei,Chengde 067000,China;不详)
出处
《河北医药》
2025年第10期1708-1711,共4页
Hebei Medical Journal
基金
河北省承德市科学技术研究与发展计划项目(编号:201904A025)。
关键词
肾细胞癌
循环肿瘤细胞
手术方式
临床特征
术后复发转移
renal cell carcinoma
circulating tumor cells
operation mode
clinical features
postoperative recurrence and metastasis
