循环中CEA阳性和EpCAM阴性的肿瘤细胞可能是胃癌患者复发的预测生物标志物,Cancer Medicine

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循环中CEA阳性和EpCAM阴性的肿瘤细胞可能是胃癌患者复发的预测生物标志物
Cancer Medicine ( IF 2.9 ) Pub Date : 2020-12-31 , DOI: 10.1002/cam4.3616
Yuichiro Miki _{1,

2} , Masakazu Yashiro _{1,

2} , Kenji Kuroda _{1,

2} , Tomohisa Okuno _{1,

2} , Shingo Togano _{1,

2} , Go Masuda _{1,

2} , Hiroaki Kasashima _{1,

2} , Masaichi Ohira ₁

Affiliation

据报道，循环肿瘤细胞（CTC）对于预测肿瘤分期或治疗反应是有益的。尽管上皮细胞粘附分子（EpCAMs）和细胞角蛋白（CK）经常被用于CTC的鉴定，但其他肿瘤标记物尚未被完全研究为CTC的检测工具。因此，本研究旨在阐明胃癌患者癌胚抗原（CEA，CD66e）阳性CTC的重要性。本研究共纳入150例胃癌患者。Ficoll富集了外周血的单核部分。通过流式细胞术根据EpCAM和CEA或CK的阳性计数细胞数。研究了这些细胞与临床病理特征的关系。平均年龄为70岁（范围28-92）。在59/11/22/38/16/4患者中，胃癌的宏观类型分别为0/1/2/3/4/5。确诊为肠道型癌症的患者为71例（47.3％），而弥漫型患者的诊断为76例（50.7％）。EpCAM-CK +，EpCAM + CK-，EpCAM + CK +，EpCAM-CEA +，EpCAM + CEA-和EpCAM + CEA +的平均细胞数分别为618、237、19.9、1147、291和7.41。II–III和IV期患者的EpCAM-CEA +细胞数量明显高于I期患者。EpCAM-CEA +细胞数量高的患者的3年RFS率（> = 622） EpCAM-CEA +细胞数量少（<622）的患者为57.5％，而为79.3％（log-rank 3％）被诊断出患有肠型癌症，而76名患者（50.7％）被诊断出患有弥漫型。EpCAM-CK +，EpCAM + CK-，EpCAM + CK +，EpCAM-CEA +，EpCAM + CEA-和EpCAM + CEA +的平均细胞数分别为618、237、19.9、1147、291和7.41。II–III和IV期患者的EpCAM-CEA +细胞数量明显高于I期患者。EpCAM-CEA +细胞数量高的患者的3年RFS率（> = 622） EpCAM-CEA +细胞数量少（<622）的患者为57.5％，而为79.3％（log-rank 3％）被诊断出患有肠型癌症，而76名患者（50.7％）被诊断出患有弥漫型。EpCAM-CK +，EpCAM + CK-，EpCAM + CK +，EpCAM-CEA +，EpCAM + CEA-和EpCAM + CEA +的平均细胞数分别为618、237、19.9、1147、291和7.41。II–III和IV期患者的EpCAM-CEA +细胞数量明显高于I期患者。EpCAM-CEA +细胞数量高的患者的3年RFS率（> = 622） EpCAM-CEA +细胞数量少（<622）的患者为57.5％，而为79.3％（log-rankp = 0.0079）。因此，我们得出结论，CEA阳性CTC将成为胃癌患者的临床有益生物标志物。

"点击查看英文标题和摘要"

Circulating CEA‐positive and EpCAM‐negative tumor cells might be a predictive biomarker for recurrence in patients with gastric cancer

It has been reported that circulating tumor cells (CTCs) are beneficial for predicting tumor stage or treatment response. Although epithelial cell adhesion molecules (EpCAMs) and cytokeratin (CK) have been often used for the identification of CTCs, other tumor markers have not been fully investigated as detecting tools for CTCs. Thus, this study aims to clarify the significance of carcinoembryonic antigen (CEA, CD66e)‐positive CTCs in patients with gastric cancer. A total of 150 patients with gastric cancer were enrolled in this study. The mononuclear fraction of peripheral blood was enriched by Ficoll. The number of cells was enumerated depending on the positivity of EpCAM and CEA or CK by flow cytometry. The association of these cells with clinicopathologic characteristics was investigated. The mean age was 70 (range 28–92). The macroscopic type of gastric cancer was classified as 0/1/2/3/4/5 in 59/11/22/38/16/4 patients, respectively. Seventy‐one patients (47.3%) were diagnosed with intestinal‐type cancer, while 76 patients (50.7%) were diagnosed with the diffuse type. The mean numbers of cells with EpCAM−CK+, EpCAM+CK−, EpCAM+CK+, EpCAM−CEA+, EpCAM+CEA−, and EpCAM+CEA+ were 618, 237, 19.9, 1147, 291, and 7.41, respectively. The number of EpCAM−CEA+cells was significantly higher in patients with stage II–III and IV than in patients with stage I. The 3‐year RFS rate in patients with a high number of EpCAM−CEA+cells (>=622) was 57.5%, while it was 79.3% in patients with a low number of EpCAM−CEA+cells (<622) (log‐rank p = 0.0079). Thus, we conclude that CEA‐positive CTCs will be a clinically beneficial biomarker in patients with gastric cancer.

更新日期：2021-02-11

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