CTCs在膀胱癌转移及预后评估中的临床应用研究

发布时间：2018-04-15 17:45

  本文选题：CTCs + 膀胱癌　； 参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]检测非肌层浸润性膀胱癌(Non muscle-invasive bladder cancer,NMIBC)患者与肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)患者外周血循环肿瘤细胞(Circulating tumor cells,CTCs)的计数及分型,探讨其在膀胱癌TNM分期及预后评估中的临床应用价值。[方法]对符合入组条件,在昆明医科大学第二附属医院泌尿外科接受腹腔镜下根治性膀胱切除术或经尿道膀胱肿瘤电切术的41例膀胱肿瘤患者,采用CanPatrolTM二代CTCs检测技术,检测外周血中的CTCs。患者年龄33岁—83岁,男性患者37例,女性患者4例。肿瘤TNM分期为:T1期15例;T2期12例;T3期9例;T4期5例;N1期6例;M1期3例。肿瘤病理组织分级为:高级别膀胱癌30例;低级别膀胱癌11例。[结果]41例膀胱癌患者总CTCs阳性率68.29%(28/41),6例淋巴结转移患者中检出CTCs阳性2例,3例远处转移患者中检出CTCs阳性1例。30例高级别膀胱癌中CTCs检出20例,占66.7%,11例低级别膀胱癌中CTCs检出7例,占63.6%。13例CTCs阴性患者中,无淋巴结转移10例(69.23%),淋巴结转移3例(30.76%)。非肌层浸润性膀胱癌高风险(G3)患者中,间质型CTCs阳性率为60%,CTCs总数≥3的患者阳性率为:60%;非肌层浸润性膀胱癌中风险(G2)患者中,间质型CTCs阳性率为20%,CTCs总数3的患者阳性率为:20%。29例患者术后随访12~41月,平均14±2月,死亡8例。术后总生存率72.41%,其中 CTCs 阳性生存率 77.77%(14/18),CTCs 阴性生存率 63.6%(7/11)。[结论]1、非肌层浸润性膀胱癌高风险(G3)患者的间质型CTCs阳性率及CTCs总数≥3的患者比例明显高于中风险(G2)患者。2、CTCs的总数及间质型CTCs的个数能够在一定程度上预测膀胱癌的恶性程度。3、CTCs的阳性检出率与膀胱癌的TNM分期、淋巴结转移、近期生存率之间未发现明显相关性。
[Abstract]:[objective] to detect the count and typing of circulating tumor cells (CTCs) in peripheral blood of patients with non muscle-invasive bladder cancer NMIBCs and those with muscle-invasive bladder cancer MIBCs.To evaluate its clinical value in TNM staging and prognosis evaluation of bladder cancer.[methods] 41 patients with bladder tumor who underwent laparoscopic radical cystectomy or transurethral resection of bladder tumor in urology department of the second affiliated Hospital of Kunming Medical University were examined by CanPatrolTM second-generation CTCs.CTCs in peripheral blood were detected.The patients were 33-83 years old, 37 male and 4 female.The TNM staging of the tumor was as follows: 15 cases of T 1 stage, 12 cases of T 2 stage, 9 cases of T 3 stage, 5 cases of T 4 stage, 6 cases of N 1 stage and 3 cases of M 1 stage.The pathological grade of the tumor was 30 cases of high grade bladder cancer and 11 cases of low grade bladder cancer.[results] the total positive rate of CTCs in 41 cases of bladder cancer was 68.29% and 28% / 41% respectively. Of the 6 cases of lymph node metastasis, 2 cases were positive for CTCs in 2 cases and 3 cases were detected for distant metastasis. 1 case was positive for CTCs in 30 cases of high grade bladder cancer, 20 cases were positive for CTCs.Of the 11 cases of low grade bladder cancer, 7 cases were detected by CTCs, accounting for 63.6%. Of the 13 cases with negative CTCs, 10 cases had no lymph node metastasis and 69.23% had no lymph node metastasis, and 3 cases had lymph node metastasis.The positive rate of interstitial type CTCs in patients with non-invasive bladder cancer with high risk of G3 was 60%. The positive rate of G2 in patients with non-invasive bladder cancer was 0. 60%, and that in patients with non invasive bladder cancer was higher than 3, and that in non invasive bladder cancer patients with high risk of G2) was higher than that in non myometrial invasive bladder cancer.The positive rate of interstitial CTCs was 3 in the total number of 20 and 20. 29 patients were followed up from 12 to 41 months after operation, with an average of 14 卤2 months and 8 dead cases.The overall survival rate was 72.41%, in which the positive survival rate of CTCs was 77.77% and the negative survival rate of 14% / 18% was 63.6% / 11%.[conclusion] 1. The positive rate of interstitial CTCs and the proportion of CTCs 鈮，

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