一项前瞻性长期随访研究：循环肿瘤细胞分析在指导 II 期结直肠癌辅助治疗中的应用。

A Prospective Long-Term Follow-Up Study: The Application of Circulating Tumor Cells Analysis to Guide Adjuvant Therapy in Stage II Colorectal Cancer.

机构信息

Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.

Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Disease, Beijing, People's Republic of China.

出版信息

Ann Surg Oncol. 2023 Dec;30(13):8495-8500. doi: 10.1245/s10434-023-14168-x. Epub 2023 Aug 19.

DOI:10.1245/s10434-023-14168-x

PMID:37598121

Abstract

BACKGROUND

The efficacy of circulating tumor cells (CTCs) in the selection of stage II colorectal cancer (CRC) patients for adjuvant chemotherapy remains inconclusive.

OBJECTIVE

The aim of this study was to validate the necessity of adjuvant chemotherapy for stage II CRC patients with positive postoperative CTCs.

METHODS

The clinicopathological features and overall survival (OS) of a cohort of 70 patients with confirmed CRC were collected and analyzed.

RESULTS

The total rate of positive CTCs was 55.7%, while the average OS was 70.8 months and the OS rate was 75.7% (53/70). These 70 patients were divided into four subgroups, including a CTC-negative group with non-adjuvant chemotherapy (CHEMO-/CTC-) versus a CTC-positive group with non-adjuvant chemotherapy (CHEMO-/CTC+), CHEMO+/CTC- versus CHEMO+/CTC+, CHEMO-/CTC- versus CHEMO+/CTC-, and CHEMO+/CTC+ versus CHEMO-/CTC+; the total numbers in each subgroup were 25 versus 32, 6 versus 7, 25 versus 6, and 7 versus 32, respectively. The average OS of the CHEMO-/CTC- and CHEMO-/CTC+ groups was 82.0 and 68.1 months, respectively (p = 0.020); the average OS of the CHEMO+/CTC- and CHEMO+/CTC+ groups was 83.6 months and 76.4 months, respectively (p = 0.963); the average OS of the CHEMO-/CTC- and CHEMO+/CTC- groups was 82.0 months and 83.6 months, respectively (p = 0.999); and the average OS of the CHEMO+/CTC+ and CHEMO-/CTC+ groups was 76.4 months and 68.1 months, respectively (p = 0.247).

CONCLUSIONS

Positive CTCs are a potential prognostic marker for stage II CRC.

摘要

背景

循环肿瘤细胞（CTC）在选择 II 期结直肠癌（CRC）患者进行辅助化疗方面的疗效仍不确定。

目的

本研究旨在验证 II 期 CRC 患者术后 CTC 阳性时接受辅助化疗的必要性。

方法

收集并分析了 70 例确诊 CRC 患者的临床病理特征和总生存期（OS）。

结果

总 CTC 阳性率为 55.7%，平均 OS 为 70.8 个月，OS 率为 75.7%（53/70）。这 70 例患者分为 4 个亚组，包括无辅助化疗的 CTC 阴性组（CHEMO-/CTC-）与无辅助化疗的 CTC 阳性组（CHEMO-/CTC+）、有辅助化疗的 CTC 阴性组（CHEMO+/CTC-）与有辅助化疗的 CTC 阳性组（CHEMO+/CTC+）、无辅助化疗的 CTC 阴性组（CHEMO-/CTC-）与有辅助化疗的 CTC 阴性组（CHEMO+/CTC-）、有辅助化疗的 CTC 阳性组（CHEMO+/CTC+）与无辅助化疗的 CTC 阳性组（CHEMO-/CTC+）；每组的总人数分别为 25 例与 32 例、6 例与 7 例、25 例与 6 例、7 例与 32 例。CHEMO-/CTC-和 CHEMO-/CTC+组的平均 OS 分别为 82.0 个月和 68.1 个月（p=0.020）；CHEMO+/CTC-和 CHEMO+/CTC+组的平均 OS 分别为 83.6 个月和 76.4 个月（p=0.963）；CHEMO-/CTC-和 CHEMO+/CTC-组的平均 OS 分别为 82.0 个月和 83.6 个月（p=0.999）；CHEMO+/CTC+和 CHEMO-/CTC+组的平均 OS 分别为 76.4 个月和 68.1 个月（p=0.247）。