循环肿瘤细胞在胶质母细胞瘤诊断和预后中的临床意义
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1.南京医科大学;2.南京医科大学第一附属医院

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基金项目:

国家自然科学基金项目(面上项目,重点项目,重大项目)


Clinical significance of circulating tumor cells in diagnosis assistance and prognosis prediction of glioblastoma
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Affiliation:

1.Nanjing Medical University;2.The First Affiliated Hospital of Nanjing Medical University

Fund Project:

The National Natural Science Foundation of China (General Program, Key Program, Major Research Plan)

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    摘要:

    目的:分析胶质瘤患者血液循环肿瘤细胞(circulating tumor cell,CTC)计数与临床指标的关系,探索CTC计数在胶质母细胞瘤(glioblastoma ,GBM)诊断协助与预后评估中的临床应用价值。方法:收集2018年10月至2022年9月就诊于南京医科大学第一附属医院神经外科的胶质瘤患者共47例,分别于术前、术后应用CTCBIOPSY? CTC分离装置对外周血中CTC进行分离和计数,比较CTC计数与血液学、影像学、预后等指标的关系。结果:术前在87.2%(41/47)的胶质瘤患者中可检测到CTC,GBM患者的术前CTC计数显著高于非GBM患者( P=0.020),术前CTC与中性粒细胞-淋巴细胞比值联用有助于GBM的术前诊断。与术前CTC相比,GBM患者术后CTC总体呈现下降,具有统计学意义(P=0.004)。以术前CTC≥11个/5ml外周静脉血为阈值可将GBM患者分为高与低CTC两组, 两组间白细胞计数(P=0.017)、中性粒细胞计数(P=0.031)以及淋巴细胞计数(P=0.018)具有统计学意义,而影像学指标未见差异。术前高CTC组的总生存期较低CTC组明显缩短(P=0.017)。结论:术前CTC计数可较好的区分GBM患者与非GBM患者,GBM患者中高CTC组预后最差,揭示CTC计数有望成为胶质母细胞瘤诊断协助和预后评估的重要指标。

    Abstract:

    Objective: To analyze the relationships between clinical parameters and number of circulating tumor cells (CTCs) isolated from glioma patients and explore their possible clinical applications in early detection and prognosis prediction of glioblastoma patients. Methods: A total of 47 patients hospitalized in the Department of Neurosurgery of The First Affiliated Hospital of Nanjing Medical University from October 2018 to September 2022 were enrolled. All patients were clinically diagnosed with glioma. CTCBIOPSY? system was utilized for CTCs isolation and counting both pre-operatively and post-operatively, after which hematological test results, radiology images and follow-up results were collected and analyzed to explore the possible relationships among parameters. Results: CTCs were detected in 87.2% (41/47) of patients pre-operatively. GBM patients showed significantly higher CTC level than non-GBM patients(P=0.020). The combination of pre-operative CTC level and neutrophil to lymphocyte ratio could aid the diagnosis of GBM. A decrease in post-operative CTC levels was observed in GBM patients and the changes were of statistical significance compared with non-GBM patients(P=0.004).GBM patients were further divided into two groups designated high-CTC and low-CTC based on a cutoff value of pre-operative CTC ≥11/5ml peripheral blood. Statistical significance was observed in white cell count(P=0.017), neutrophil count(P=0.031), and lymphocyte count(P=0.018), but not in radiology features. Follow-up data of GBM patients showed significantly shortened overall survival in GBM-H patients than GBM-L patients (P=0.017). Conclusion: Pre-operative CTC counting readily distinguishes GBM from non-GBM patients and predicts adverse prognosis in GBM patients with higher pre-operative CTCs. It is a feasible candidate marker to aid the diagnosis and prognosis prediction of GBM.

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  • 收稿日期:2022-11-23
  • 最后修改日期:2023-03-14
  • 录用日期:2023-05-23
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