Page 65 - 南京医科大学学报自然科学版

第43卷第6期 南京医科大学学报（自然科学版）
2023年6月 Journal of Nanjing Medical University（Natural Sciences） ·807 ·

·临床研究·

循环肿瘤细胞在胶质母细胞瘤诊断和预后中的临床意义

曹博文 ，吴志强 ，于瑞磊 ，王协锋 ，张军霞 ，尤永平 1*
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南京医科大学第一附属医院神经外科，放射科，江苏 南京 210029
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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计数在协
助胶质母细胞瘤（glioblastoma，GBM）诊断与预后评估中的临床应用价值。方法：收集2018年10月—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
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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 总体呈现下降趋势，差异具有统计学意义（P=0.004）。以术前每 5 mL 外周静脉血
CTC≥11个为阈值可将GBM患者分为高CTC组与低CTC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）差异有统计学意义，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计数可较好地区分GBM患者与非GBM患者。高CTC组GBM患者预后最差，揭示CTC计数有望成为
协助GBM诊断和预后评估的重要指标。
［关键词］ 胶质母细胞瘤；循环肿瘤细胞；中性粒细胞；生存分析
［中图分类号］ R739.41 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）06⁃807⁃07
doi：10.7655/NYDXBNS20230609

Clinical significance of circulating tumor cells in the diagnosis and prognosis prediction of
glioblastoma

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CAO Bowen ，WU Zhiqiang ，YU Ruilei ，WANG Xiefeng ，ZHANG Junxia ，YOU Yongping 1*
Department of Neurosurgery，Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，
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Nanjing 210029，China
［Abstract］ Objective：The current study aims to analyze the correlation between clinical parameters and number of circulating
tumor cells（CTC）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 between October 2018 and September 2022 were enrolled. All patients were
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clinically diagnosed with glioma. CTCBIOPSY system was utilized for CTC 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：CTC was 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 statistical significant compared with non⁃GBM patients（P=0.004）. GBM patients were further divided into two groups
that designated high⁃CTC group and low⁃CTC group based on a cutoff value of the pre⁃operative CTC ≥11 per 5 mL of peripheral
venous 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 high⁃CTC
group than low⁃CTC group（P=0.017）. Conclusion：Pre⁃operative CTC counting readily distinguishes GBM from non⁃GBM patients

［基金项目］ 国家自然科学基金（81974389）
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通信作者（Corresponding author），E⁃mail：YYPL9@njmu.edu.cn