一项前瞻性长期跟踪研究：循环肿瘤细胞分析在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.
发表日期：2023 Aug 19
作者：
Junhui Yu, Yanyan Bai, Lan Jin, Zhongtao Zhang, Yingchi Yang
来源：
ANNALS OF SURGICAL ONCOLOGY
摘要：
环行肿瘤细胞（CTCs）在选择II期结肠直肠癌（CRC）患者用于辅助化疗的疗效尚不确定。本研究旨在验证具有术后CTC阳性的II期CRC患者是否需要辅助化疗。收集和分析了一组70名确诊CRC患者的临床病理特征和总生存（OS）数据。CTC阳性率为55.7％，平均OS为70.8个月，OS率为75.7％（53/70）。这70名患者分为四个亚组：非辅助化疗CTC阴性组（CHEMO-/CTC-）与非辅助化疗CTC阳性组（CHEMO-/CTC+），辅助化疗CTC阴性组（CHEMO+/CTC-）与辅助化疗CTC阳性组（CHEMO+/CTC+），非辅助化疗CTC阴性组与辅助化疗CTC阴性组（CHEMO-/CTC- vs CHEMO+/CTC-），辅助化疗CTC阳性组与非辅助化疗CTC阳性组（CHEMO+/CTC+ vs CHEMO-/CTC+）；各亚组人数分别为25 vs 32，6 vs 7，25 vs 6，7 vs 32。CHEMO-/CTC-组和CHEMO-/CTC+组的平均OS分别为82.0个月和68.1个月（p = 0.020）；CHEMO+/CTC-组和CHEMO+/CTC+组的平均OS分别为83.6个月和76.4个月（p = 0.963）；CHEMO-/CTC-组和CHEMO+/CTC-组的平均OS分别为82.0个月和83.6个月（p = 0.999）；CHEMO+/CTC+组和CHEMO-/CTC+组的平均OS分别为76.4个月和68.1个月（p = 0.247）。CTC阳性可以作为II期CRC的潜在预后标志。© 2023年外科肿瘤学会。
The efficacy of circulating tumor cells (CTCs) in the selection of stage II colorectal cancer (CRC) patients for adjuvant chemotherapy remains inconclusive.The aim of this study was to validate the necessity of adjuvant chemotherapy for stage II CRC patients with positive postoperative CTCs.The clinicopathological features and overall survival (OS) of a cohort of 70 patients with confirmed CRC were collected and analyzed.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).Positive CTCs are a potential prognostic marker for stage II CRC.© 2023. Society of Surgical Oncology.