Oncology:隐匿性肿瘤细胞是胃癌患者预后不佳的“指示灯”

2015-08-28 MedSci MedSci原创

目前,胃癌居于中国各种恶性肿瘤首位,胃癌患者的预后与胃癌的病理分期、部位、组织类型、生物学行为以及治疗措施相关。研究表明,在胃癌(GC)切除术后,无区域淋巴结(LN)转移可作为胃癌患者长期生存率的重要预测指标。然而,即便患者没有出现淋巴结转移,临床上亦可能出现患者胃癌复发的情况。在这些情况下,隐匿性肿瘤细胞(OTC)可能在其中发挥了重要作用。 葡萄牙波尔图大学的研究人员,对2013年9月

目前,胃癌居于中国各种恶性肿瘤首位,胃癌患者的预后与胃癌的病理分期、部位、组织类型、生物学行为以及治疗措施相关。研究表明,在胃癌(GC)切除术后,无区域淋巴结(LN)转移可作为胃癌患者长期生存率的重要预测指标。然而,即便患者没有出现淋巴结转移,临床上亦可能出现患者胃癌复发的情况。在这些情况下,隐匿性肿瘤细胞(OTC)可能在其中发挥了重要作用。

葡萄牙波尔图大学的研究人员,对2013年9月之前在英国发表的有关胃腺癌患者隐匿性肿瘤细胞患病率(包括技术、标记和检测方法),以及隐匿性肿瘤细胞作为胃癌患者预后的潜在预测指标的文献,进行了一次系统回顾(文献均从MEDLINE数据库中检索)。同时,研究人员也对患者的肿瘤特点、治疗和随访情况进行分析。旨在探讨隐匿性肿瘤细胞的患病率及其临床关联性。

结果显示,免疫组织化学检查(IHC)和/或聚合酶链反应(PCR)是隐匿性肿瘤细胞最常用的检测方法。使用免疫组织化学检查对隐匿性肿瘤细胞进行检测时,胃癌患者隐匿性肿瘤细胞的患病率为9 - 88%不等,淋巴结中隐匿性肿瘤细胞患病率为0.4 -42%不等;使用聚合酶链反应对隐匿性肿瘤细胞进行检测时,胃癌患者隐匿性肿瘤细胞的患病率为17 - 46%不等,淋巴结中隐匿性肿瘤细胞患病率为3 -33%不等。在隐匿性肿瘤细胞对胃癌复发的预测作用评估的研究中(n = 24),8项研究表明隐匿性肿瘤细胞与胃癌复发间没有相关性,18项研究表明隐匿性肿瘤细胞意味着不良预后,然而,仅有6项研究表明,淋巴结微小转移对胃癌患者的5年生产率间具有显著相关性。

鉴于以上结果,波尔图大学的研究人员认为隐匿性肿瘤细胞的出现很可能意味着胃癌患者预后不佳。

原始出处:

Amelia Tavares , Matilde MonteiroSoares et al. Occult Tumor Cells in Lymph Nodes of Patients with Gastric Cancer: A Systematic Review on Their Prevalence and Predictive Role.Oncology. 2015 Jul 7

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    2016-05-08 minlingfeng
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