摘要
目的:探索改良免疫磁珠富集联合免疫荧光细胞化学技术(IME-FICC)检测鼻咽癌患者外周血循环肿瘤细胞(CTCs)的临床意义。方法:取76例初治鼻咽癌患者外周血,分离单个核细胞,用与磁珠共价结合的上皮细胞黏附分子(EpCAM)抗体富集外周血中表达EpCAM的肿瘤细胞,再采用宽波段滤板检测细胞角蛋白(CK)8/18阳性的肿瘤细胞。中位随访25个月后,对包括循环肿瘤细胞在内的预后因子做统计分析。结果:20例正常人的外周血中未检测到CK8/18,63例鼻咽癌患者的外周血检测到CK8/18,阳性率为82.9%(63/76,P<0.01)。复发患者治疗前检测到的外周血CK8/18+CTC中位数明显高于不复发患者(P<0.01),两组中位病毒壳蛋白抗原(VCA)-IgA滴度无显著差异(P>0.05)。外周血CK8/18+CTCs个数在3以上,无复发生存率逐渐下降。VCA-IgA滴度不能预测生存。结论:外周血中CK8/18+CTCs是初治鼻咽癌患者的预后不良因素。
AIM：To investigate the clinical significance of the new method of modified immunomagnetic enrichment of tumor cells in combination with fluorescent immunocytochemistry to detect circulating tumor cells（CTCs） in peripheral blood samples of patients with nasopharyngeal cancer（NPC）.METHODS： Peripheral blood samples were obtained from 76 histology-proven patients with NPC before the initial therapy.After isolation of the mononuclear cells,the CTCs expressing cytokeratin（CK）8/18 in the blood samples were detected by the method of immunomagnetic enrichment in combination with fluorescent immunocytochemistry.The magnetic beads covalent binding with epithelial cell adhesion molecule（EpCAM） antibody were used to enrich the tumor cells which expressed EpCAM.After median following-up for 25 months,the effects of CTCs and other prognostic factors on patient prognosis were thoroughly investigated.RESULTS： None of the positive CK8/18 cells was detected in 20 normal blood samples.The CTCs were detected in 82.9% of the patients（P0.01）.Relapse patients had significantly higher number of median CK8/18＋ CTCs than the patients without relapse（P〈0.01）.No association of viral capsid antigen（VCA）-IgA（P〈0.05） was observed between the patients with and without relapse.Relapse-free survival rates were lower when the number of peripheral blood CK8/18＋ CTCs was more than 3.The 2-year relapse-free survival rates were 100%,100%,100%,94.1%,71.4%,53.3% and 44.4%（P〈0.01） when the numbers of peripheral blood CK8/18＋ CTCs were 0,1,2,3,4,5,6 before treatment,respectively.Overall survival rates were lower when the number of peripheral blood CK8/18＋ CTCs was more than 5,but the difference was not significant.The 2-year overall survival rates were 100%,100%,100%,100%,100%,100%,80% and 77.8%（P〉0.05） when the numbers of peripheral blood CK8/18＋ CTCs were 0,1,2,3,4,5,6 before treatment,respectively.The VCA-IgA titer could not predict survivals.Cox multivariate analysis also showed the same results.CONCLUSION： Peripheral blood CK8/18＋ CTCs are a prognostic factor for initial treatment of NPC.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2011年第10期1896-1901,共6页
Chinese Journal of Pathophysiology
基金
国家自然科学青年基金资助项目(No.81001052)
广东省科技计划资助项目(No.2011B031800222)
中山大学肿瘤防治中心青年优才资助项目
关键词
鼻咽肿瘤
循环肿瘤细胞
免疫磁珠富集
免疫细胞化学
Nasopharyngeal neoplasms
Circulating tumor cells
Immunomagnetic enrichment
Immunocytochemistry
