探讨基于纳米技术的检测方法在 II-IV 期结直肠癌中循环肿瘤细胞的诊断和预后意义。
Exploring the diagnostic and prognostic significance of circulating tumor cells in stage II-IV colorectal cancer using a nano-based detection method.
机构信息
Department of Throatic Surgery, East Hospital of Tongji University School of Medicine, Shanghai, China.
Department of Oncology, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, China.
出版信息
J Chin Med Assoc. 2024 Oct 1;87(10):945-952. doi: 10.1097/JCMA.0000000000001143. Epub 2024 Aug 21.
BACKGROUND
Colorectal cancer (CRC) is a leading cause of cancer mortality globally, underscoring the urgency for a noninvasive and effective biomarker to enhance patient prognosis. Circulating tumor cells (CTCs), a potential marker for real-time tumor monitoring, are limited in clinical utility due to the low sensitivity of existing detection methods. Previously, we introduced a novel nano-based CTCs detection method that relies on the electrical properties of cell surfaces, thus eliminating the need for specific molecular biomarkers. In this study, we used this technique to evaluate the diagnostic and prognostic value of CTCs in stage II-IV CRC.
METHODS
A total of 194 participants were included, consisting of 136 CRC patients and 58 healthy individuals. The peripheral blood of the participants was collected, and CTC enumeration was performed utilizing the nano-based detection method that we newly developed. The receiver operating characteristic (ROC) curve and multivariate Cox proportional-hazards analysis were used to assess the effectiveness of CTCs for diagnosing CRC and predicting patient prognosis.
RESULTS
The nano-based method demonstrated an ability to differentiate CRC patients from healthy individuals with a sensitivity of 84.6% and a specificity of 94.8%. Furthermore, baseline CTC levels were predictive of progression-free survival (PFS) in CRC patients, with lower levels associated with longer PFS compared to higher levels (4.5 vs 8.0 months at 15 CTCs/mL, p = 0.016; 4.4 vs 8.0 months at 20 CTCs/mL, p = 0.028). We also explored the dynamic changes in the number of CTCs after 1 to 5 cycles of chemotherapy. Patients with increasing CTC levels typically experienced disease progression (PD), while those with decreasing levels often achieved a partial response (PR) or maintained stable disease (SD). These findings suggest that the dynamic fluctuations in CTC counts are closely tied to the clinical course of the disease.
CONCLUSION
Our study indicates the potential of nano-based CTCs detection in diagnosing and predicting outcomes for patients with stage II-IV CRC.
背景
结直肠癌（CRC）是全球癌症死亡的主要原因，这突显了迫切需要一种非侵入性和有效的生物标志物来改善患者预后。循环肿瘤细胞（CTC）是实时肿瘤监测的潜在标志物，但由于现有检测方法的敏感性较低，其临床应用受到限制。此前，我们引入了一种新的基于纳米的 CTC 检测方法，该方法依赖于细胞表面的电学特性，从而无需特定的分子生物标志物。在这项研究中，我们使用该技术评估了 II-IV 期 CRC 患者的 CTC 的诊断和预后价值。
方法
共纳入 194 名参与者，包括 136 名 CRC 患者和 58 名健康个体。采集参与者的外周血，并利用我们新开发的基于纳米的检测方法进行 CTC 计数。使用受试者工作特征（ROC）曲线和多变量 Cox 比例风险分析评估 CTC 对 CRC 诊断和预测患者预后的有效性。
结果
基于纳米的方法能够以 84.6%的敏感性和 94.8%的特异性区分 CRC 患者和健康个体。此外，基线 CTC 水平可预测 CRC 患者的无进展生存期（PFS），与较高水平相比，较低水平与较长的 PFS 相关（15 CTCs/mL 时为 4.5 个月与 8.0 个月，p = 0.016；20 CTCs/mL 时为 4.4 个月与 8.0 个月，p = 0.028）。我们还探讨了化疗 1-5 个周期后 CTC 数量的动态变化。CTC 水平升高的患者通常会发生疾病进展（PD），而 CTC 水平降低的患者通常会获得部分缓解（PR）或疾病稳定（SD）。这些发现表明 CTC 计数的动态波动与疾病的临床过程密切相关。
结论
我们的研究表明，基于纳米的 CTC 检测在诊断和预测 II-IV 期 CRC 患者的结局方面具有潜力。
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