Translational Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
BMC Cancer. 2018 Aug 20;18(1):835. doi: 10.1186/s12885-018-4744-4.
This study explored the effect of liver resection on perioperative circulating tumor cells (CTCs) and found that the prognostic significance of surgery was associated with changes in CTC counts in patients with hepatocellular carcinoma (HCC).
One hundred thirty-nine patients with HCC were consecutively enrolled. The time-points for collecting blood were one day before operation and three days after operation. CTCs in the peripheral blood were detected by the CellSearch™ System.
Both CTC detection incidence and mean CTC counts showed greater increases postoperatively (54%, mean 1.54 cells) than preoperatively (43%, mean 1.13 cells). The postoperative CTC counts increased in 41.7% of patients, decreased in 25.2% of patients and did not change in 33.1% of patients. The increase in postoperative CTC counts was significantly associated with the macroscopic tumor thrombus status. Patients with increased postoperative CTC counts (from preoperative CTC < 2 to postoperative CTC ≥ 2) had significantly shorter disease-free survival (DFS) and overall survival (OS) than did patients with persistent CTC < 2. Patients with persistent CTC levels of ≥2 had the worst prognoses.
Surgical liver resection is associated with an increase in CTC counts, and increased postoperative CTC numbers are associated with a worse prognosis in patients with HCC.
本研究探讨了肝切除术对围手术期循环肿瘤细胞（CTC）的影响，发现手术的预后意义与肝癌（HCC）患者 CTC 计数的变化相关。
连续纳入 139 例 HCC 患者。采集血液的时间点为术前一天和术后三天。外周血中的 CTCs 通过 CellSearch™系统检测。
术后 CTC 检测发生率和平均 CTC 计数均高于术前（54%，平均 1.54 个细胞；43%，平均 1.13 个细胞）。术后 41.7%的患者 CTC 计数增加，25.2%的患者 CTC 计数减少，33.1%的患者 CTC 计数无变化。术后 CTC 计数的增加与肿瘤栓子的宏观状态显著相关。与持续 CTC<2 的患者相比，术后 CTC 计数增加（从术前 CTC<2 到术后 CTC≥2）的患者无病生存率（DFS）和总生存率（OS）显著缩短。持续 CTC 水平≥2 的患者预后最差。
手术切除肝脏与 CTC 计数的增加相关，术后 CTC 数量的增加与 HCC 患者的预后较差相关。
