CEA、PAK5联合循环肿瘤细胞对Ⅲ B期胃癌患者术后复发转移的早期精准预测

史健; 袁梦

doi:10.3971/j.issn.1000-8578.2020.19.0494

CEA、PAK5联合循环肿瘤细胞对Ⅲ B期胃癌患者术后复发转移的早期精准预测

史健,
袁梦

Early and Accurate Prediction of Postoperative Recurrence and Metastasis in Stage Ⅲ B Gastric Cancer Patients by Combination of CEA, PAK5 and Circulating Tumor Cells

SHI Jian,
YUAN Meng

摘要

摘要:
目的探讨CEA、PAK5联合循环肿瘤细胞(CTC)对ⅢB期胃癌患者术后复发转移的早期精准预测作用。
方法 ELISA法、多重RNA/DNA原位分析法，对150例ⅢB期胃癌术后患者进行外周静脉血动态检测癌胚抗原(CEA)、PAK5、CTC及同时期影像学CT检查。对照组50例，实验组100例。实验组按CEA水平增高情况分为：CEA进行性增高组(实验A组, n=50)和无规律增高组(实验B组, n=50)。
结果单因素检测结果显示：CEA：按生物学进展时间(T2)：实验A组3~24月，中位时间13月; 实验B组4~32月，中位时间为22月。按影像进展时间(T3)：实验A组39例(78%)进展，出现时间5~8月，中位时间6.2月; 实验B组12例(24%)进展，出现时间4~15月，中位时间10.6月。51例影像学确诊进展的患者，T2时刻PAK5中表达范围为13.6%~83%，T3时刻PAK5高表达范围为37.8%~100%。CTC检测结果显示：当混合型+间质型/总细胞数比值> 30%时可预测生物学进展，混合型和间质型之和/总单细胞数比值> 50%和(或)间质型细胞数≥1可预测影像学CT进展。联合检测多因素结果显示：实验A组影像学进展39例患者CEA、PAK5、CTC阳性表达三者之间一致性在生物学进展时刻为82%;影像CT进展时刻为94%。
结论联合检测CEA、PAK5、CTC可作为早期预测ⅢB期胃癌术后复发转移的生物学指标。

Abstract:
Objective To investigate the early and accurate prediction of recurrence and metastasis of stage ⅢB gastric cancer by CEA, PAK5 combined with CTC.
Methods ELISA and multiple RNA/DNA in situ analysis were used to detect CEA, PAK5, CTC and imaging CT at the same time in 150 patients with stage ⅢB gastric cancer. Patients were divided into CEA progressive increase group (group A, n=50), CEA irregular increase group (group B, n=50) and control group (n=50).
Results CEA: the median time of biological progress (T2) in the group A was 13(3-24) months, and that of the group B was 22(4-32) months; 39(78%) cases in group A had image progression and the median occurrence time of image progression (T3) was 6.2(5-8) months, and those were 12(24%) cases and 10.6(4-15) months in group B. The medium expression range of PAK5 at T2 was 13.6%-83% and the high expression range of PAK5 at T3 was 37.8%-100% in 51 patients with image progression. CTC test showed that the ratio of mixed type + interstitial type/total cell number > 30% could predict the biological progress time, and the ratio of mixed type + interstitial type/total single cell number > 50% and (or) interstitial-type cell number ≥1 could predict the imaging CT progression. In 39 patients with image progression in group A, the consistency of positive expression of CEA, PAK5 and CTC was 82% at biological progression time and 94% at image CT progression time.
Conclusion Combined detection of CEA, PAK5 and CTC could early predict the recurrence and metastasis of stage Ⅲ B gastric cancer.

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