Elche University Hospital, Elche, Alicante, Spain.
Clin Transl Oncol. 2010 Feb;12(2):142-7. doi: 10.1007/S12094-010-0479-7.
Recent studies have identified both the prognostic and predictive utility of determining the number of circulating tumour cells (CTC) in patients with solid cancers.
In the present pilot study we evaluated the ability of two different methods to isolate CTC in combination with two strategies to enumerate CTC from patients with stages II and III surgically treated colorectal cancer (CRC). First, we used two systems for tumour cell enrichment (differential centrifugation and immunomagnetic beads), combined with two methods to enumerate CTC (real-time PCR and fl ow cytometry), to determine the most efficient combination. These experiments were performed in a model system using serial dilutions of HT29 tumour cell lines with lymphocytes. Then, CTC analysis using the technical approach selected before was performed in 109 blood samples from 16 stage II and III CRC patients during chemotherapy treatment and follow-up.
Immunomagnetic beads followed by flow cytometry was the most efficient combination (ED=60.53; p=0.5). Two cases out of 16 patients analysed had clinical tumour relapse. In both, we detected a significant increase of CTC five and six months, respectively, before the relapse was clinically evidenced. An increase of CTC was also observed in another case without clinical evidence of relapse. The remaining cases (13) had very few or no detectable CTC and no clinical evidence of relapse (p=0.029).
Changes in CTC numbers during follow-up might predict tumour relapse. Further evaluation of CTC prognostic and predictive value in patients with early CRC is warranted.
最近的研究已经确定了确定实体瘤患者循环肿瘤细胞（CTC）数量的预后和预测效用。
在本初步研究中，我们评估了两种不同的方法在联合两种策略时从接受手术治疗的 II 期和 III 期结直肠癌（CRC）患者中分离 CTC 的能力。首先，我们使用了两种肿瘤细胞富集系统（差速离心和免疫磁珠），结合两种 CTC 计数方法（实时 PCR 和流式细胞术），以确定最有效的组合。这些实验是在使用 HT29 肿瘤细胞系与淋巴细胞进行系列稀释的模型系统中进行的。然后，在 16 名接受化疗治疗和随访的 II 期和 III 期 CRC 患者的 109 份血样中，使用之前选择的技术方法进行 CTC 分析。
免疫磁珠结合流式细胞术是最有效的组合（ED=60.53；p=0.5）。在分析的 16 名患者中有 2 例发生临床肿瘤复发。在这两例中，我们分别在复发临床证据出现前 5 个月和 6 个月检测到 CTC 的显著增加。在另一个没有复发临床证据的病例中也观察到 CTC 的增加。其余病例（13 例）的 CTC 数量很少或无法检测到，且无临床复发证据（p=0.029）。
随访期间 CTC 数量的变化可能预示着肿瘤复发。需要进一步评估 CTC 在早期 CRC 患者中的预后和预测价值。
