Guo Xin, Wu Yuan-Zhou, Jia Long-Fei, Li Ya-Ling, Yan Yu-Sheng, Chen Qun-Qing
Department of Cardiothoracic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2018 Mar 20;38(3):318-323. doi: 10.3969/j.issn.1673-4254.2018.03.12.
To investigate the effects of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) on the level of circulating tumor cells (CTCs) in patients with esophageal cancer (EC).
A total of 73 patients with EC undergoing MIE (n=38) or OE (n=35) in our department between October, 2015 and October, 2017 were enrolled, with 10 patients with benign esophagus disease and 10 healthy volunteers as controls. The levels of CTCs in the peripheral blood of the participants were detected using CanPatrol technique and analyzed for their association with the operation methods and perioperative complications.
CTCs were detected in 60.3% (44/73) of the EC patients but in none of the control subjects. CTC level after the surgery was significantly higher than that during the surgery, and CTC level during the surgery was significantly higher than that before surgery (P<0.001). The preoperative and intra-operative CTC levels were not significantly different between MIE and OE groups (P>0.05), but the postoperative CTC level was significantly lower in MIE group than in OE group, and postoperative increment of CTC level (from the preoperative level) was significantly lower in MIE group than in OE group (P<0.001). The total incidence of postoperative complications was significantly lower in MIE group than in OE group (28.9% vs 54.3%, P=0.023), and in both groups, CTC levels in patients with complications were significantly higher than those in patients without complications (P=0.001 and P=0.005 in MIE and OE groups, respectively).
MIE may help to reduce the number of peripheral blood CTCs early after the operation, and dynamic monitoring CTCs level assists in evaluation of the prognosis of EC patients. CTC level may serve as an indicator for monitoring the prognosis of EC.
探讨微创食管癌切除术（MIE）与开放食管癌切除术（OE）对食管癌（EC）患者循环肿瘤细胞（CTC）水平的影响。
选取2015年10月至2017年10月在我科接受MIE（n = 38）或OE（n = 35）治疗的73例EC患者，另选10例良性食管疾病患者及10名健康志愿者作为对照。采用CanPatrol技术检测参与者外周血中CTC水平，并分析其与手术方式及围手术期并发症的关系。
73例EC患者中60.3%（44/73）检测到CTC，而对照组均未检测到。术后CTC水平显著高于术中，术中CTC水平显著高于术前（P < 0.001）。MIE组与OE组术前及术中CTC水平差异无统计学意义（P > 0.05），但MIE组术后CTC水平显著低于OE组，且MIE组术后CTC水平较术前的升高幅度显著低于OE组（P < 0.001）。MIE组术后并发症总发生率显著低于OE组（28.9%对54.3%，P = 0.023），且两组中发生并发症患者的CTC水平均显著高于未发生并发症患者（MIE组和OE组分别为P = 0.001和P = 0.005）。
MIE可能有助于术后早期减少外周血CTC数量，动态监测CTC水平有助于评估EC患者预后。CTC水平可作为监测EC预后的指标。
