阿司匹林对转移性结直肠癌和乳腺癌患者循环肿瘤细胞的影响：一项 II 期试验研究。
The effect of aspirin on circulating tumor cells in metastatic colorectal and breast cancer patients: a phase II trial study.
机构信息
Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People's Hospital, Hangzhou Medicine College, Hangzhou, 310014, Zhejiang, People's Republic of China.
Department of Breast and Thyroid Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.
出版信息
Clin Transl Oncol. 2018 Jul;20(7):912-921. doi: 10.1007/s12094-017-1806-z. Epub 2017 Dec 14.
PURPOSE
Aspirin could reduce the risk of cancer metastasis. Circulating tumor cells (CTCs) are a key factor of cancer metastasis, but no evidence has revealed how aspirin affects CTCs and its epithelial-mesenchymal transition (EMT). Here, we conducted a clinical trial to investigate how aspirin affects CTCs in metastatic colorectal cancer (MCC) and breast cancer patients (MBC).
METHODS
The trial is retrospective registered at clinicaltrials.gov (NCT02602938). The eligible patients are given 100 mg aspirin q.d. for 8 weeks, and CTCs are evaluated at baseline, 4 and 8 weeks for absolute number, phenotype (epithelial type, E+, mesenchymal type, M+, and biophenotypic type, B+), and vimentin expression.
RESULTS
Data on 21 MCC and 19 MBC patients are analyzed, and it revealed that the CTC numbers decreased with aspirin treatment in MCC (p < 0.001) but not MBC (p = 0.0532); besides, ratio of E+ CTCs increased (p = 0.037) and M+ CTCs decreased at 2 months in MCC (p = 0.013), but neither the ratio of E+ or M+ CTCs changes significantly in MBC; vimentin expression of M+ CTCs is higher than E+ and B+ CTCs either in MBC or MCC patients at baseline (p < 0.01); and aspirin suppresses the vimentin expression in M+ (p = 0.002)and B+ (p = 0.006) CTCs of MCC and M+ CTCs of MBC (p = 0.004); besides it find vimentin expression in B+ (p = 0.004) or M+ (p < 0.001), CTCs are markedly decreased in patients with total CTC numbers declined.
CONCLUSION
Aspirin could decrease CTCs numbers and block EMT transition in MCC patients and part of MBC patients.
目的
阿司匹林可能降低癌症转移风险。循环肿瘤细胞（CTCs）是癌症转移的关键因素，但尚无证据表明阿司匹林如何影响 CTCs 及其上皮-间充质转化（EMT）。在此，我们开展了一项临床试验，以探究阿司匹林对转移性结直肠癌（MCC）和乳腺癌（MBC）患者 CTCs 的影响。
方法
该试验于临床研究.gov 网站（NCT02602938）进行回顾性注册。符合条件的患者每天服用 100mg 阿司匹林，连续 8 周，分别在基线、4 周和 8 周时评估 CTCs 的绝对数量、表型（上皮型，E+；间充质型，M+；双表型，B+）和波形蛋白表达。
结果
分析了 21 例 MCC 和 19 例 MBC 患者的数据，结果显示阿司匹林治疗后 MCC 患者的 CTC 数量减少（p<0.001），但 MBC 患者无显著变化（p=0.0532）；此外，MCC 患者 2 个月时 E+CTC 比例增加（p=0.037），M+CTC 比例减少（p=0.013），但 MBC 患者 E+或 M+CTC 比例均无明显变化；无论在 MCC 还是 MBC 患者中，基线时 M+CTC 的波形蛋白表达均高于 E+和 B+CTC（p<0.01）；阿司匹林抑制 MCC 中 M+（p=0.002）和 B+（p=0.006）CTC 以及 MBC 中 M+CTC 的波形蛋白表达（p=0.004）；此外，在总 CTC 数量下降的患者中，B+（p=0.004）或 M+（p<0.001）CTC 的波形蛋白表达显著降低。
结论
阿司匹林可能降低 MCC 患者和部分 MBC 患者的 CTCs 数量并阻断 EMT 转化。
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