Wang Xiaoguang, Hu Lingyu, Yang Xiaodan, Chen Fei, Xu Haokai, Yu Haitao, Song Zhengwei, Fei Jianguo, Zhong Zhengxiang
Department of Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China.
Exp Ther Med. 2021 Oct;22(4):1140. doi: 10.3892/etm.2021.10574. Epub 2021 Aug 8.
Pancreatic cancer (PC) is a highly malignant tumor type with a high early metastasis rate and no obvious symptoms. Gemcitabine is a first-line chemotherapeutic drug for PC. Since there is no distinct method to determine the efficacy of chemotherapy with gemcitabine in patients with PC, the purpose of the present study was to determine whether positivity for circulating tumor cells (CTCs) in patients with advanced PC is associated with response to gemcitabine chemotherapy and to explore whether CTCs may be used as a predictor of prognosis of patients with advanced PC undergoing chemotherapy. First, immunomagnetic microspheres (magnetic beads; MIL) were prepared to detect CTCs. The patients' clinical characteristics and survival data, as well as efficacy and adverse effects of chemotherapy, were prospectively obtained and their association with CTCs was analyzed. The results indicated that CTC-positive patients with advanced PC had a higher probability of developing resistance to gemcitabine chemotherapy than CTC-negative patients. Survival in the CTC-negative group was significantly higher than in the CTC-positive group (χ=14.58, P<0.001). CTC-positive patients with advanced PC also had shorter progression-free survival (PFS) after chemotherapy with gemcitabine (P=0.01). In conclusion, CTC-positive patients with PC are more likely to develop gemcitabine resistance, have poor PFS and low incidence of thrombocytopenia. CTCs are expected to become a prognostic indicator for chemotherapy response in patients with PC.
胰腺癌（PC）是一种高度恶性的肿瘤类型，早期转移率高且无明显症状。吉西他滨是PC的一线化疗药物。由于尚无明确方法确定吉西他滨化疗对PC患者的疗效，本研究的目的是确定晚期PC患者循环肿瘤细胞（CTC）阳性是否与吉西他滨化疗反应相关，并探讨CTC是否可作为晚期PC化疗患者预后的预测指标。首先，制备免疫磁微球（磁珠；MIL）以检测CTC。前瞻性获取患者的临床特征、生存数据以及化疗的疗效和不良反应，并分析它们与CTC的相关性。结果表明，晚期PC的CTC阳性患者对吉西他滨化疗产生耐药的可能性高于CTC阴性患者。CTC阴性组的生存率显著高于CTC阳性组（χ=14.58，P<0.001）。晚期PC的CTC阳性患者在接受吉西他滨化疗后的无进展生存期（PFS）也较短（P=0.01）。总之，PC的CTC阳性患者更易产生吉西他滨耐药，PFS较差且血小板减少症发生率较低。CTC有望成为PC患者化疗反应的预后指标。
