Li Shu-Ping, Guan Quan-Lin, Zhao Da, Pei Guang-Jun, Su Hong-Xin, Du Lan-Ning, He Jin-Xiang, Liu Zhao-Chen
Department of Radiation Oncology, First Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland).
Department of Oncology, First Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland).
Med Sci Monit. 2016 May 17;22:1654-62. doi: 10.12659/msm.898335.
BACKGROUND Circulating tumor cells (CTCs) are tumor cells that leave the primary tumor site and enter the bloodstream, where they can spread to other organs; they are very important in the diagnosis, treatment, and prognosis of malignant tumors. However, few studies have investigated CTCs in esophageal squamous cell carcinoma (ESCC). The aim of this study was to investigate the CTCs in blood of ESCC patients and its potential relevance to clinicopathological features and prognosis. MATERIAL AND METHODS CTCs were acquired by a negative enrichment method that used magnetic activated cell sorting (MACSTM). Fluorescent immunohistochemistry (IHC) was used to identify the CTCs. Then, the positive CTC patients with ESCC were analyzed, after which the relationship between CTCs and clinicopathologic features was evaluated. RESULTS In the present study, 62 out of 140 (44.3%) patients with ESCC were positive for CTCs. The positive rate of CTCs was significantly related with stage of ESCC patients (P=0.013). However, there was no relationship between CTC status and age, sex, smoking tumor history, tumor location, differentiation of tumor, lymphatic invasion, or lymph venous invasion (P>0.05). Kaplan-Meier analysis showed that patients positive for CTCs had significantly shorter survival time than patients negative for CTCs. Multivariate analysis demonstrated that stage and CTC status were significant prognostic factors for patients with ESCC. CONCLUSIONS CTCs positivity is an independent prognostic biomarker that indicates a worse prognosis for patients with ESCC.
背景 循环肿瘤细胞（CTCs）是离开原发肿瘤部位并进入血液循环的肿瘤细胞，在血液循环中它们能够扩散至其他器官；循环肿瘤细胞在恶性肿瘤的诊断、治疗及预后方面非常重要。然而，很少有研究对食管鳞状细胞癌（ESCC）中的循环肿瘤细胞进行调查。本研究旨在调查ESCC患者血液中的循环肿瘤细胞及其与临床病理特征和预后的潜在相关性。
材料与方法 采用磁珠分选法（MACSTM）通过阴性富集方法获取循环肿瘤细胞。使用荧光免疫组织化学（IHC）鉴定循环肿瘤细胞。然后，对ESCC阳性循环肿瘤细胞患者进行分析，之后评估循环肿瘤细胞与临床病理特征之间的关系。
结果 在本研究中，140例ESCC患者中有62例（44.3%）循环肿瘤细胞呈阳性。循环肿瘤细胞阳性率与ESCC患者的分期显著相关（P = 0.013）。然而，循环肿瘤细胞状态与年龄、性别、吸烟史、肿瘤位置、肿瘤分化、淋巴浸润或淋巴管浸润之间无相关性（P>0.05）。Kaplan-Meier分析显示，循环肿瘤细胞阳性患者的生存时间明显短于循环肿瘤细胞阴性患者。多因素分析表明，分期和循环肿瘤细胞状态是ESCC患者的重要预后因素。
结论 循环肿瘤细胞阳性是一种独立的预后生物标志物，表明ESCC患者预后较差。
