Yinxing Zhu, Nan Chen, Manman Chen, Xiaowen Cui, Han Yang, Xuedan Zhu, Jiali Dai, Yang Gong, Dongying Gu, Xinying Huo, Huanhuan Huang, Cuiju Tang
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引用次数: 7
Abstract
Background: Circulating tumor cells and serum tumor markers have been found significant in predicting outcome for several malignancies. However, their role in gastric cancer is not fully clarified. We conducted a retrospective study to explore the prognostic value of circulating tumor cells and their applicability in assessing the treatment efficacy in gastric cancers.
Methods: From September 2015 to December 2018, 116 patients with newly pathologically diagnosed gastric adenocarcinoma were enrolled. At both baseline and two courses after chemotherapy, the data of circulating tumor cells and serum tumor markers, such as CEA, CA72-4, CA19-9, CA50, and CA242, were collected. The relationships between the change trend of circulating tumor cells and the treatment efficacy were analyzed after chemotherapy, with a paired t-test. Univariate and multivariable analysis were used to find prognostic factors for overall survival (OS).
Results: We found there is a significant difference between the circulating tumor cells-positive and circulating tumor cells-negative before and after therapy (mOS 12.6 vs. 31.6 months, P<0.001; mOS 12.4 vs. 24.2 months, P=0.002), respectively. Also, differentiation, pre-therapeutic circulating tumor cells and therapeutic response were independent predictors of overall survival. Following two courses of chemotherapy, the number of circulating tumor cells increased obviously in the progressive disease group (P=0.002), while they decreased in the non-progressive disease group (P=0.02). Thus, the change in the circulating tumor cells count had a close association with the therapeutic response (P=0.004).
Conclusion: Generally, circulating tumor cells provide a novel tool to evaluate the outcomes of gastric cancer patients. Since the change of circulating tumor cells was highly related to treatment response, it may be an auxiliary to assess the effect of chemotherapy, leading an earlier adjustment of following regimens.
背景:循环肿瘤细胞和血清肿瘤标志物已被发现在预测几种恶性肿瘤的预后方面具有重要意义。然而，它们在胃癌中的作用尚不完全清楚。我们进行回顾性研究，探讨循环肿瘤细胞的预后价值及其在胃癌治疗疗效评估中的适用性。方法:选取2015年9月至2018年12月新病理诊断的胃腺癌患者116例。在基线和化疗后2个疗程，收集循环肿瘤细胞及血清肿瘤标志物CEA、CA72-4、CA19-9、CA50、CA242等数据。分析化疗后循环肿瘤细胞变化趋势与治疗效果的关系，采用配对t检验。采用单因素和多因素分析寻找影响总生存期(OS)的预后因素。结果:我们发现治疗前后循环肿瘤细胞阳性与循环肿瘤细胞阴性比较有显著性差异(mOS 12.6 vs. 31.6月，P0.001;mOS分别为12.4月和24.2月，P=0.002)。此外，分化、治疗前循环肿瘤细胞和治疗反应是总生存期的独立预测因子。2个疗程化疗后，进展性疾病组循环肿瘤细胞数明显增加(P=0.002)，非进展性疾病组循环肿瘤细胞数明显减少(P=0.02)。因此，循环肿瘤细胞计数的变化与治疗反应密切相关(P=0.004)。结论:循环肿瘤细胞为评价胃癌患者预后提供了一种新的工具。由于循环肿瘤细胞的变化与治疗反应高度相关，因此它可以作为评估化疗效果的辅助手段，引导后续方案的早期调整。
期刊介绍：
IJBM is an international, online only, peer-reviewed Journal, which publishes original research and critical reviews primarily focused on cancer biomarkers. IJBM targets advanced topics regarding the application of biomarkers in oncology and is dedicated to solid tumors in adult subjects. The clinical scenarios of interests are screening and early diagnosis of cancer, prognostic assessment, prediction of the response to and monitoring of treatment.
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