微流控芯技术检测循环肿瘤细胞在脑胶质瘤预后预测中的价值

doi:10.19401/j.cnki.1007-3639.2021.10.005

摘要/Abstract

摘要： 背景与目的：脑胶质瘤患者的预后既往多通过生化指标进行预测，临床实践中有一定难度且受多种因素影响，导致预测效率相对较差。探讨微流控芯技术检测循环肿瘤细胞（circulating tumor cell，CTC）在脑胶质瘤预后预测中的价值。方法：选取2016年3月—2020年3月内蒙古自治区人民医院神经外科收治的96例脑胶质瘤患者为研究对象，采用微流控芯技术富集患者外周血CTC，并利用免疫荧光法对CTC进行鉴定；采用logistic回归方程分析脑胶质瘤患者外周血CTC的检测结果与脑胶质瘤临床特征之间的关系并建立受试者工作特征（receiver operating characteristic，ROC）曲线；制作并分析脑胶质瘤患者术后生存曲线。结果：微流控芯技术对CTC富集联合免疫荧光结果显示，CTC检测阳性率为42.71%，外周血检测出的CTC数目为（66.27±6.36）/mL；单因素分析结果显示，外周血CTC与患者的肿瘤分期、组织学类型、淋巴结转移是否存在囊性病变、神经元特异性烯醇化酶（neuron-specific enolase，NSE）密切相关（P<0.05），与年龄、性别、KPS评分、血清胶质纤维酸性蛋白（glial fibrillary acidic protein，GFAP）含量等临床特征无相关性；多因素分析结果显示肿瘤分期、组织学类型及NSE的表达与CTC密切相关；通过ROC曲线分析得出肿瘤分期、组织学类型以及NSE的AUC分别为0.645、0.687、0.720，预测概率AUC为0.814（P<0.05）；CTC阳性组和阴性组患者1年生存率差异无统计学意义（P>0.05），但两组患者2年和3年生存率差异有统计学意义（P<0.05）。结论：微流控芯技术可定量检测脑胶质瘤患者外周血CTC，其水平与肿瘤分期、组织学类型、NSE密切相关，直接影响脑胶质瘤患者远期生存率。因此，外周血CTC可作为脑胶质瘤患者预后预测的重要指标。

关键词: 微流控芯技术, 循环肿瘤细胞, 胶质瘤, 预后

Abstract: Background and purpose: IIn the past, the prognosis of glioma was mainly predicted by biochemical indicators. In clinical practice, it is difficult to predict the prognosis of glioma due to the contamination of various factors, which leads to relatively poor prediction efficiency. This study aimed to investigate the value of circulating tumor cells (CTCs) by microfluidic core in the diagnosis and prognosis of gliomas. Methods: A total of 96 patients with brain glioma admitted to the Department of Neurosurgery in People's Hospital of Inner Mongolia Autonomous Region from March 2016 to March 2020 were studied. CTCs were enriched in peripheral blood by microfluidic core technology, and identified by immunofluorescence method. The regression model was used to analyze the relationship between the detection of CTCs in peripheral blood of glioma patients and the clinical characteristics of glioma patients. The receiver operating characteristic (ROC) curve was established, and the survival curve was made to analyze CTCs test results and the postoperative survival time of glioma patients. Results: CTCs enrichment by microfluidic core technology combined with immunofluorescence showed CTCs with a positive detection rate of 42.71%, and the number of CTCs detected in peripheral blood was (66.27±6.36)/mL. Univariate analysis showed that CTC in peripheral blood was closely correlated to tumor stage, histological type, cystic lymph node metastasis and neuron-specific enolase (NSE) (P<0.05), but had no correlation with age, gender, smoking status Cartesian functional status score, glial fibrillary acidic protein (GFAP) content and other clinical characteristics. Multivariate analysis showed that tumor stage, histological type, NSE expression and CTCs were closely related. The area under the curve (AUC) of tumor stage, histological type and NSE were 0.645, 0.687 and 0.720, respectively, and the predictive probability AUC was 0.814 (P<0.05). The CTCs test results and the postoperative survival curve of glioma patients were analyzed. Conclusion: The microfluidic core technology established in this study can quantitatively detect peripheral blood CTCs in patients with glioma, whose CTCs level is closely related to tumor stage, histological type and NSE, and directly affects the long-term survival rate of patients with glioma. Therefore, peripheral blood CTCs can be used as an important indicator for the diagnosis and prognosis of glioma patients, providing a new idea for clinical research.

Key words: Microfluidic core technology, Circulating tumor cells, Glioma, Prognosis

杨通衢, 韩志桐, 赵卫平, 陈云照, 张大鹏, 张瑞剑 . 微流控芯技术检测循环肿瘤细胞在脑胶质瘤预后预测中的价值[J]. 中国癌症杂志, 2021, 31(10): 905-911.

YANG Tongqu , HAN Zhitong , ZHAO Weiping , CHEN Yunzhao , ZHANG Dapeng , ZHANG Ruijian . The prognostic value of microfluidic core technology in detecting circulating tumor cells in brain glioma[J]. China Oncology, 2021, 31(10): 905-911.

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微流控芯技术检测循环肿瘤细胞在脑胶质瘤预后预测中的价值

The prognostic value of microfluidic core technology in detecting circulating tumor cells in brain glioma

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