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首页> 外文期刊>Journal of Clinical Oncology >Clinical significance of circulating tumor cells, including cancer stem-like cells, in peripheral blood for recurrence and prognosis in patients with dukes' stage B and C colorectal cancer.
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Clinical significance of circulating tumor cells, including cancer stem-like cells, in peripheral blood for recurrence and prognosis in patients with dukes' stage B and C colorectal cancer.

机译：公爵的B期和C期大肠癌患者外周血中循环的肿瘤细胞（包括癌干样细胞）对复发和预后的临床意义。

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PURPOSE Using multiple genetic markers, including cancer stem-like cells, we evaluated the clinical significance of circulating tumor cells (CTCs) as a prognostic factor for overall survival (OS) and disease-free survival (DFS) in the peripheral blood (PB) of patients with colorectal cancer (CRC) who had undergone curative surgery. PATIENTS AND METHODS In a multi-institutional study, 735 patients with CRC were assigned to a retrospective training set (n = 420) or prospective validation set (n = 315). CTCs that expressed carcinoembryonic antigen (CEA), cytokeratin (CK) 19, CK20, and/or CD133 (CEA/CK/CD133) mRNA in PB were detected using real-time reverse transcription polymerase chain reaction assay. Results In the training sets, OS and DFS of patients who were positive for CEA/CK/CD133 were significantly worse than those of patients who were negative for these markers (P < .001). At each staging analysis, OS and DFS of patients with Dukes' stage B or C cancer who were positive for CEA/CK/CD133 were significantly worse than those of patients who were negative for these markers (P < .003 and P < .001 in Dukes' stage B; P < .001 in Dukes' stage C). In contrast, in patients with Dukes' stage A, no significant differences were seen between patients who were positive for these markers and those who were negative. Cox multivariate analysis demonstrated that CEA/CK/CD133 was a significant prognostic factor for OS (hazard ratio [HR], 3.84; 95% CI, 2.41 to 6.22; P < .001) and DFS (HR, 3.02; 95% CI, 1.83 to 5.00; P < .001). In particular, in patients with Dukes' stage B and C cancer, CEA/CK/CD133 demonstrated significant prognostic value. In validation sets, similar results were confirmed in patients with Dukes' stage B and C cancer. CONCLUSION In patients with Dukes' stage B and C CRC who require adjuvant chemotherapy, detection of CEA/CK/CD133 mRNA in PB is a useful tool for determining which patients are at high risk for recurrence and poor prognosis.
机译：目的使用多种遗传标志物，包括癌症干细胞样细胞，我们评估循环肿瘤细胞（CTC）作为外周血（PB）总体生存率（OS）和无病生存率（DFS）的预后因素的临床意义接受过根治性手术的结直肠癌（CRC）患者的比例。患者和方法在一项多机构研究中，将735例CRC患者分配到回顾性训练集（n = 420）或前瞻性验证集（n = 315）。使用实时逆转录聚合酶链反应分析法检测了PB中表达癌胚抗原（CEA），细胞角蛋白（CK）19，CK20和/或CD133（CEA / CK / CD133）mRNA的CTC。结果在训练组中，CEA / CK / CD133阳性的患者的OS和DFS显着低于这些指标阴性的患者（P <.001）。在每次分期分析中，CEA / CK / CD133阳性的Dukes的B或C期癌症患者的OS和DFS显着低于这些指标阴性的患者（P <.003和P <.001在Dukes阶段B中; P <.001在Dukes阶段C中）。相比之下，在Dukes A期患者中，这些标志物阳性的患者和阴性的患者之间没有发现显着差异。 Cox多因素分析表明，CEA / CK / CD133是OS（危险比[HR]，3.84; 95％CI，2.41至6.22; P <.001）和DFS（HR，3.02; 95％CI， 1.83至5.00; P <0.001）。特别是，在Dukes的B和C期癌症患者中，CEA / CK / CD133显示出显着的预后价值。在验证集中，在Dukes的B期和C期癌症患者中证实了相似的结果。结论对于需要辅助化疗的Dukes B期和C期CRC患者，检测PB中CEA / CK / CD133 mRNA是确定哪些患者复发风险高和预后不良的有用工具。

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