Romiti Adriana, Raffa Salvatore, Di Rocco Roberta, Roberto Michela, Milano Annalisa, Zullo Angelo, Leone Laura, Ranieri Danilo, Mazzetta Francesca, Medda Emanuela, Sarcina Ida, Barucca Viola, D'Antonio Chiara, Durante Valeria, Ferri Mario, Torrisi Maria Rosaria, Marchetti Paolo
Clinical and Molecular Medicine Department, Sapienza University, Sant'Andrea Hospital, Italy.
Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Italy.
J Gastrointestin Liver Dis. 2014 Sep;23(3):279-84. doi: 10.15403/jgld.2014.1121.233.arom1.
Data on the potential of circulating tumor cells (CTC) count in predicting overall survival (OS) in patients with colorectal cancer are timely and worthy of interest. This study aimed to evaluate the prognostic role of CTC count in both localized and metastatic colorectal cancer patients.
Consecutive patients with histological diagnosis of colorectal cancer were enrolled. CTC count was performed, by using a quantitative immunofluorescence method, at baseline (T0) and 1 month following start of chemotherapy (T1). A CTC count <2 was considered negative, whilst a CTC level >/= 2 was positive. Overall survival was calculated accordingly.
A total of 75 colorectal cancer patients were enrolled, including 54 stages I-III and 21 stage IV patients. Overall, 21 (28%) patients had a positive CTC count at baseline, and it was significantly associated with a worse prognosis as compared to a negative status (OS: 36.2 vs. 61.6 months; P = 0.002). CTC count remained positive after chemotherapy in 22.4% of the patients and it was an independent prognostic factor of OS (P = 0.03; Hazard Ratio: 3.55; 95% CI: 1.1-11.5).
This study found that the presence of CTCs is associated with a reduced survival in colorectal cancer patients. Further studies aimed at testing such a predictive value in early stage colorectal cancer are awaited.
关于循环肿瘤细胞(CTC)计数在预测结直肠癌患者总生存期(OS)方面潜力的数据具有时效性且值得关注。本研究旨在评估CTC计数在局限性和转移性结直肠癌患者中的预后作用。
纳入经组织学诊断为结直肠癌的连续患者。在基线期(T0)和化疗开始后1个月(T1),采用定量免疫荧光法进行CTC计数。CTC计数<2被视为阴性,而CTC水平≥2为阳性。据此计算总生存期。
共纳入75例结直肠癌患者,包括54例I - III期和21例IV期患者。总体而言,21例(28%)患者在基线期CTC计数为阳性,与阴性状态相比,其预后明显较差(总生存期:36.2个月对61.6个月;P = 0.002)。22.4%的患者化疗后CTC计数仍为阳性,且它是总生存期的独立预后因素(P = 0.03;风险比:3.55;95%可信区间:1.1 - 11.5)。
本研究发现CTC的存在与结直肠癌患者生存期缩短相关。期待进一步开展研究以检验其在早期结直肠癌中的预测价值。