结肠镜检查结肠癌期间血行性肿瘤细胞播散
Hematogenous tumor cell dissemination during colonoscopy for colorectal cancer.
作者信息
Koch M, Kienle P, Sauer P, Willeke F, Buhl K, Benner A, Lehnert T, Herfarth C, von Knebel Doeberitz M, Weitz J
机构信息
Division for Molecular Diagnostics and Therapy, Department of Surgery, University of Heidelberg, INF 110, D-69120 Heidelberg, Germany.
出版信息
Surg Endosc. 2004 Apr;18(4):587-91. doi: 10.1007/s00464-003-9066-0. Epub 2004 Jan 23.
BACKGROUND
It has long been suspected that mechanical influences may enhance the release of viable colorectal cancer cells into the circulation. The objective of this study was to determine the extent of hematogenous tumor cell spread in colorectal cancer patients during colonoscopy.
METHODS
Peripheral venous blood samples were taken before and after colonoscopy from 44 patients with colorectal cancer. Blood samples were examined using a reverse-transcriptase polymerase chain reaction assay to amplify cytokeratin 20 transcripts.
RESULTS
Eleven patients with colorectal cancer displayed circulating tumor cells before and after colonoscopy (25%), whereas tumor cells were detected in six of 44 patients (14%) only after the procedure (p = 0.03, McNemar's test: tumor cell detection before after colonoscopy). All control samples consistently tested negative.
CONCLUSIONS
Mechanical forces may result in enhanced release of viable colorectal cancer cells into the circulation; however, the clinical significance of these results needs to be clarified.
背景
长期以来一直怀疑机械性影响可能会促使存活的结肠直肠癌细胞释放进入循环系统。本研究的目的是确定结肠镜检查期间结肠直肠癌患者血行性肿瘤细胞播散的程度。
方法
对44例结肠直肠癌患者在结肠镜检查前后采集外周静脉血样本。使用逆转录聚合酶链反应测定法检测血样，以扩增细胞角蛋白20转录本。
结果
11例结肠直肠癌患者在结肠镜检查前后均显示有循环肿瘤细胞（25%），而仅在检查后在44例患者中的6例（14%）检测到肿瘤细胞（p = 0.03，McNemar检验：结肠镜检查前后肿瘤细胞检测情况）。所有对照样本检测结果均持续为阴性。
结论
机械力可能导致存活的结肠直肠癌细胞更多地释放进入循环系统；然而，这些结果的临床意义尚需阐明。
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