Yang Liu, Zeng Xiaojiao, Yang Gui, Li Yirong, Pan Yunbao
Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, No.169 Donghu Road, Wuchang District, Wuhan, 430071, China.
Int J Clin Oncol. 2023 Aug;28(8):1011-1022. doi: 10.1007/s10147-023-02355-5. Epub 2023 May 27.
This study aimed to evaluate the prognostic value of circulating tumor cell (CTC) in tumor patients during treatment.
This study retrospectively analyzed clinical data obtained from 174 cancer patients during treatment. The relationship between the CTC counts and clinicopathological variables was analyzed. A ROC curve was applied to determine the optimal cut-off values and assess the predictive ability of the prognostic indicators. The overall survival (OS) for different prognostic factors was calculated using the Kaplan-Meier method, and the difference between the survival curves was then compared using the log-rank test. Cox regression model was used to investigate the effect of independent factors on patients' survival.
The CTC-positive rate was positively correlated with the clinicopathological variables of TNM stage, tumor differentiation, serum CEA level, and ki-67%. In the differential analysis of hematological microenvironment parameters in CTC-positive and CTC-negative samples, the complete blood count, blood biological chemistry, tumor markers (CEA, CA19-9, CA72-4), and lymphocyte subpopulation were statistically significant. The results of the ROC curve analysis indicated that the serum CEA level was the best diagnostic indicator to discriminate the CTC count in tumor patients. Additionally, the results of the univariate and multivariate analyses of OS in relation to clinical variables revealed that the CTC counts were an independent prognostic factor for unfavorable OS.
The CTC counts in patients with tumors undergoing treatment were significantly correlated with hematological microenvironment parameters. The detection of CTCs may therefore be used as an indicator of tumor prognosis.
本研究旨在评估循环肿瘤细胞（CTC）在肿瘤患者治疗期间的预后价值。
本研究回顾性分析了174例癌症患者治疗期间获得的临床资料。分析了CTC计数与临床病理变量之间的关系。应用ROC曲线确定最佳临界值并评估预后指标的预测能力。采用Kaplan-Meier法计算不同预后因素的总生存期（OS），然后使用对数秩检验比较生存曲线之间的差异。采用Cox回归模型研究独立因素对患者生存的影响。
CTC阳性率与TNM分期、肿瘤分化、血清CEA水平和ki-67%的临床病理变量呈正相关。在CTC阳性和CTC阴性样本的血液微环境参数差异分析中，血常规、血液生化、肿瘤标志物（CEA、CA19-9、CA72-4）和淋巴细胞亚群具有统计学意义。ROC曲线分析结果表明，血清CEA水平是鉴别肿瘤患者CTC计数的最佳诊断指标。此外，OS与临床变量的单因素和多因素分析结果显示，CTC计数是OS不良的独立预后因素。
接受治疗的肿瘤患者的CTC计数与血液微环境参数显著相关。因此，检测CTC可作为肿瘤预后的指标。
