循环肿瘤细胞作为 III 期结直肠癌切除术后预后标志物的作用。

Role of circulating tumor cells as prognostic marker in resected stage III colorectal cancer.

机构信息

Department of Medical Oncology.

Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid.

出版信息

Ann Oncol. 2015 Mar;26(3):535-41. doi: 10.1093/annonc/mdu568. Epub 2014 Dec 15.

DOI:10.1093/annonc/mdu568

PMID:25515656

Abstract

BACKGROUND

The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients.

PATIENTS AND METHODS

Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis.

RESULTS

CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89).

CONCLUSION

CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.

摘要

背景

循环肿瘤细胞（CTC）在早期结直肠癌（CRC）中的预后作用尚未确定。我们评估了 CTC 在 III 期 CRC 患者中的潜在预后价值。

患者和方法

这是一项前瞻性多中心研究，共纳入 519 例 2009 年 1 月至 2010 年 6 月期间接受 III 期 CRC 治疗的患者。在原发肿瘤切除后和辅助治疗开始前，使用 CellSearch 系统对 CTC 进行计数。共有 472 例患者纳入分析。

结果

166（35%）、93（20%）、57（12%）和 34（7%）例患者分别检测到 CTC≥1、≥2、≥3 和≥5。中位随访时间为 40 个月。在总体人群中，CTC≥1（无病生存期（DFS）：HR 0.97，P=0.85；总生存期（OS）：HR 1.03，P=0.89）、≥2（DFS：HR 1.07，P=0.76；OS：HR 1.02，P=0.95）、≥3（DFS：HR 0.96，P=0.87；OS：HR 0.74，P=0.41）和≥5（DFS：HR 0.72，P=0.39；OS：HR 0.48，P=0.21）与较差的 DFS 和 OS 无关。无临床病理特征与 CTC 的存在显著相关。在疾病复发的患者中，单一和多个转移部位患者的 CTC≥1 比例无显著差异（37.9%比 31.4%，P=0.761）。在多变量分析中，CTC≥1 不是 DFS（HR 0.97，P=0.87）和 OS（HR 0.96，P=0.89）的独立预后因素。