间充质循环肿瘤细胞和CD133的表达与结直肠癌预后的相关性分析
Correlation analysis of the expression of mesenchymal circulating tumor cells and CD133 with the prognosis of colorectal cancer.
作者信息
Zhou Huijun, Shen Hua, Xiang Fang, Yang Xiaolin, Li Rongrong, Zeng Yidong, Liu Zhenyang
机构信息
Department of Gastroenterology and Urology Medicine I, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University Changsha 410013, Hunan, China.
出版信息
Am J Transl Res. 2023 May 15;15(5):3489-3499. eCollection 2023.
OBJECTIVE
To evaluate the expression of tumor stem cell marker CD133 in peripheral blood circulating tumor cells (CTC) and the value of CD133 in prognosis of patients with colorectal cancer (CRC).
METHODS
Preoperative/pre-chemotherapy peripheral blood samples of 63 patients with CRC from January 2016 to January 2021 were selected to detect peripheral blood CTC by CanPatrol CTC enrichment technology. Expression of CD133 in different epithelial-mesenchymal transition (EMT) typing CTC was analyzed. Clinical data (including tumor size, tumor stage, pathological typing, molecular typing, lymph node metastasis, distant metastasis, carcinoembryonic antigen (CEA), and CA-199 expression), PFS time and OS time were followed up. The expression of CD133 in different CTCs was compared, and the correlation between CD133 and patient survival time was compared.
RESULTS
The positive rate of E-CTC in patients with tumor diameter ≥5 cm was significantly higher than that of patients with tumor diameter <5 cm (P=0.035). The positive rate of M-CTC in patients with diabetes was significantly higher than that of patients without diabetes (P=0.006). The CD133-positive M-CTCs were significantly higher in DM and CEA>5 ng/mL patients than in non-DM and CEA≤5 ng/mL patients (P<0.001, P=0.0195). Fifty-five patients were followed up for a median of 14 months. During follow-up, 19 had disease progression and five died. According to the cutoff point obtained by ROC analysis, the PFS of M-CTC>2.5/5 ml patients (0%) was lower than that of ≤2.5/5 ml patients (76.5%), P<0.05. PFS in patients with CD133-positive M-CTC>0.5/5 mL (18.6%) was lower than in patients with ≤0.5/5 ml (76.5%), P<0.05. However, thedifference in the OS between patients with CD133-positive M-CTC>0.5/5 ml (71.7%) and those with ≤0.5/5 ml (93.8%), was not significant, P=0.054.
CONCLUSION
CD133 positive M-CTC is closely related to distant metastasis in CRC. The expression of CD133 in CTC, especially in M-CTC, can be used as a prognostic indicator for colorectal cancer.
目的
评估肿瘤干细胞标志物CD133在结直肠癌（CRC）患者外周血循环肿瘤细胞（CTC）中的表达情况以及CD133在CRC患者预后中的价值。
方法
选取2016年1月至2021年1月期间63例CRC患者术前/化疗前的外周血样本，采用CanPatrol CTC富集技术检测外周血CTC。分析不同上皮-间质转化（EMT）分型的CTC中CD133的表达情况。对临床资料（包括肿瘤大小、肿瘤分期、病理分型、分子分型、淋巴结转移、远处转移、癌胚抗原（CEA）和CA-199表达）、无进展生存期（PFS）时间和总生存期（OS）时间进行随访。比较不同CTC中CD133的表达情况，并比较CD133与患者生存时间的相关性。
结果
肿瘤直径≥5 cm患者的上皮型CTC（E-CTC）阳性率显著高于肿瘤直径<5 cm的患者（P = 0.035）。糖尿病患者的间质型CTC（M-CTC）阳性率显著高于非糖尿病患者（P = 0.006）。糖尿病且CEA>5 ng/mL患者的CD133阳性M-CTC显著高于非糖尿病且CEA≤5 ng/mL的患者（P<0.001，P = 0.0195）。55例患者接受了中位时间为14个月的随访。随访期间，19例疾病进展，5例死亡。根据ROC分析得到的截断点，M-CTC>2.5/5 ml患者的PFS（0%）低于≤2.5/5 ml患者（76.5%），P<0.05。CD133阳性M-CTC>0.5/5 mL患者的PFS（18.6%）低于≤0.5/5 ml患者（76.5%），P<0.05。然而，CD133阳性M-CTC>0.5/5 ml患者（71.7%）与≤0.5/5 ml患者（93.8%）的OS差异无统计学意义，P = 0.054。
结论
CD133阳性M-CTC与CRC的远处转移密切相关。CTC中CD133的表达，尤其是M-CTC中的表达，可作为结直肠癌的预后指标。
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