Data on the Recurrence of Breast Tumors Fit a Model in which Dormant Cells are Subject to Slow Attrition but Can Randomly Awaken to Become Malignant

We successfully modeled the recurrence of tumors in breast cancer patients, assuming that:(i) A breast cancer patient is likely to have some circulating metastatic cells, even after initial surgery. (ii) These metastatic cells are dormant. (iii) The dormant cells are subject to attrition by the body’s immune system, or by random apoptosis or senescence.(iv) Recurrence suppressor mechanisms exist. (v) When such genes are disabled by random mutations, the dormant metastatic cell is activated, and will develop to a cancer recurrence. The model was also fitted to data on the survival of pancreatic cancer patients. The time course of cancer recurrence in a group of poor prognosis breast cancer patients could not be linked to the over- (or under-) expression of any gene in the primary tumors from which the recurrent tumors derived. Thus, the recurrence of the tumor in breast cancer patients appears to be a random event. Inasmuch as the kinetics of cancer recurrence in published data sets closely follows the model found for the appearance of sporadic retinoblastoma, tumor recurrence could be triggered by mutations in awakening-suppressor mechanisms. The retinoblastoma tumor suppressor gene was identified by tracing its occurrence in familial retinoblastoma pedigrees. Will it be possible to track the postulated cancer recurrence, awakening suppressor gene(s) in early recurrence breast cancer patients?     

E-cadherin在胃癌术后复发预测中的临床意义

目的:探讨E-cadherin在胃癌术后复发预测中的临床意义。方法:选择我院2006年1月至2010年7月收治的胃癌或者胃食管连接部癌行胃癌根治性切除术后259例患者为研究对象,将其分为术后复发组(115例)和术后未复发组(144例),采用免疫组织化学方法检测其E-cadherin的表达,并分析E-cadherin的异常表达与胃癌术后复发的相关性。结果:胃癌癌旁正常组织与胃癌组织间E-cadherin的表达有显著差异(P0.05);胃癌术后复发与未复发患者的胃癌组织E-cadherin的表达比较有显著差异(P0.05)。E-cadherin的异常表达与胃癌的浸润深度、淋巴结转移和TNM分期显著相关(P0.05)。单因素Logistic回归分析发现,E-cadherin的异常表达的与胃癌术后复发有显著的相关性(P=0.039,RR=1.711,95%Cl为1.486-1.970)。结论:E-cadherin的异常表达与胃癌根治性切除术后复发显著相关。     

血清HE4、VEGF、MCP-1及CCL20与乳腺癌患者保乳术后局部复发的关系研究

摘要 目的：探讨血清人附睾蛋白4（HE4）、血管内皮生长因子（VEGF）、单核细胞趋化因子-1（MCP-1）及CC趋化因子配体20（CCL20）与乳腺癌患者保乳术后局部复发的关系。方法：选择2015年7月~2018年7月期间本院收治的乳腺癌患者312例作为研究对象,均符合保乳术手术指征,成功实施乳腺癌保乳术,所有患者均随访3年。检测两组血清HE4、VEGF、MCP-1、CCL20水平情况,单因素及多因素Logistic回归分析影响术后局部复发的因素。使用受试者工作特征（ROC）曲线分析HE4、VEGF、MCP-1、CCL20水平单独及联合检测对保乳术后局部复发的预测价值。结果：随访过程中失访6例,剩余的306例患者根据随访结果,分为局部复发组27例、无局部复发组279例,局部复发率为8.82%。局部复发组的血清HE4、VEGF、MCP-1、CCL20水平均高于无局部复发组（P<0.05）。单因素分析结果显示,乳腺癌患者保乳术后局部复发与年龄、淋巴结转移、切缘状态、人表皮生长因子受体2（Her-2）、细胞增殖相关抗原（Ki-67）、术后规范化疗、术后足程放疗有关（P<0.05）。多因素Logistic回归分析结果显示术后规范化疗、年龄偏高、术后足程放疗是保乳术后局部复发的保护因素,HE4、VEGF、MCP-1、CCL20水平偏高,切缘状态、Her-2、Ki-67阳性以及淋巴结转移是保乳术后局部复发的危险因素（P<0.05）。HE4、VEGF、MCP-1、CCL20联合应用预测乳腺癌患者保乳术后局部复发的效能高于单一指标应用。结论：乳腺癌保乳术后局部复发患者体内HE4、VEGF、MCP-1、CCL20水平高表达,四指标联合检测可辅助预测保乳术后局部复发。且乳腺癌患者保乳术后复发还受到切缘状态、Her-2、Ki-67等多种因素的影响。     

A possible association between survival time and transfusion in cervical cancer

Some studies suggest that transfusion may be associated with an increased risk of recurrence of and death due to malignant human neoplasms. We examined retrospective data from patients with cervical cancer to see if any association between transfusion of blood at the time of initial treatment and the time interval to recurrence and death could be detected in this cancer. In 130 patients with cervical cancer, seen over a ten-year period at our institution, there was a trend toward earlier recurrence in transfused patients, but this trend did not achieve statistical significance. Death due to cervical cancer recurrence occurred after a median of Death due to cervical cancer recurrence occurred after a median of 12 months in the transfused patients and a median of 68 months in the non-transfused individuals, which was statistically significant. Transfused patients had, on average, more favorable prognostic factors than those not transfused, such as less advanced clinical stage of disease. Analysis using a proportional hazards risk model failed to demonstrate a significant association between transfusion and time to recurrence when other prognostic factors were considered, but a significant association between transfusion and time to cancer-related death (p less than 0.05) was found. While these results cannot be viewed as conclusive due to the small number and heterogeneity of the patients analyzed, our data support the possibility of an association between transfusion and cervical cancer survival. Further studies are warranted to confirm or refute this relationship.     

Serum prolactin responses to TRH in recurrent breast cancer patients.

The response of serum prolactin (PRL) to thyrotropin-releasing hormone (TRH) was evaluated by radioimmunoassay in 6 normal women and 44 breast cancer cases. They were divided into the following 5 groups: group 1:6 normal women; group 2:10 preoperative patients with early breast cancer; group 3:13 preoperative patients with advanced cancer; group 4:13 postoperative patients with no recurrence of cancer for more than 2 years; group 5:8 postoperative patients with cancer recurrence. The maximum increment of serum PRL levels following the administration of TRH was significantly higher in groups 2, 3 and 5 than in groups 1 and 4. These results indicate that patients with recurrent breast cancer have a higher PRL response to TRH than those without recurrence of cancer.     

Association between transfusion of whole blood and recurrence of cancer.

Transfusion affects the immune response to renal transplantation and may be associated with recurrence of various human neoplasms. Data from patients with colonic, rectal, cervical, and prostate tumours showed an association between transfusion of any amount of whole blood or larger amounts of red blood cells at the time of surgery and later recurrence of cancer. Recipients of one unit of whole blood had a significantly higher incidence of recurrence (45%) than recipients of a single unit of red cells (12%) (p = 0.03). Recipients of two units of whole blood also had a higher rate of recurrence (52%) than those receiving two units of red cells (23%) (p = 0.03). Recipients of any amount of whole blood had similar recurrence rates (38-52%). Recipients of four or more units of red blood cells had a higher rate of recurrence (55%) than those receiving three or fewer units of red blood cells (20%) (p = 0.005). Mortality due to cancer in patients receiving three or fewer units of red blood cells (2%) was similar to that in patients who did not have transfusions (7%) and significantly lower than that observed in patients receiving three or fewer units of whole blood (20%) (p = 0.003). A proportional hazards risk analysis showed that transfusion of any whole blood or more than three units of red blood cells was significantly associated with earlier recurrence and death due to cancer. These data support an association between transfusion and recurrence of cancer. They also suggest that some factor present in greater amounts in whole blood, such as plasma, may contribute to the increased risk of recurrence in patients who have undergone transfusion. Until the questions raised by retrospective studies of cancer recurrence and transfusion can be answered by prospective interventional trials with washed red blood cells, red blood cells should be transfused to patients with cancer in preference to whole blood when clinically feasible.     

超声造影定量参数联合癌胚抗原、中性粒细胞/淋巴细胞比值对乳腺癌改良根治术后复发转移的预测价值

摘要 目的：探讨超声造影定量参数联合癌胚抗原（CEA）、中性粒细胞/淋巴细胞比值（NLR）对乳腺癌改良根治术后复发转移的预测价值。方法：选择2020年12月至2022年1月我院收治的120例行改良根治术治疗的乳腺癌患者,所有患者均行乳腺超声造影检查获得超声造影特征图像及超声造影定量参数,检测血清CEA水平和NLR,统计术后复发转移的发生情况。受试者工作特征（ROC）曲线分析超声造影定量参数联合CEA、NLR预测乳腺癌改良根治术后复发转移的价值。结果：两组术前超声造影特征比较,复发转移组增强强度略高,大部分为高增强或整体增强,造影剂分布尚均匀。18例术后发生复发转移（复发转移组）,复发转移组峰值强度（PI）大于未复发转移组,血清CEA水平和NLR高于未复发转移组,达峰时间（TTP）小于未复发转移组（P＜0.05）。PI、TTP、CEA、NLR预测乳腺癌改良根治术后复发转移的曲线下面积（AUC）为0.693、0.764、0.763、0.781,联合PI、TTP、CEA和NLR预测乳腺癌改良根治术后复发转移的AUC为0.909,大于各指标单独预测。结论：乳腺癌改良根治术后复发转移患者超声造影参数PI增大、TTP降低,血清CEA和NLR增高,联合检测TTP、PI、CEA和NLR在乳腺癌改良根治术后复发转移中具有较高的预测价值。     

Clinical evaluation of sizofiran combined with irradiation in patients with cervical cancer. A randomized controlled study; a five-year survival rate

Following a previous report we ascertained the effectiveness of sizofiran (Schizophyllan:SPG) to prolong the survival and time to recurrence of the patients with Stage II or III cervical cancer, as evaluated in a 5-year randomized controlled study conducted in 19 institutions in Japan. Of the overall patients with Stage II or III cancer, time to recurrence and survival rate in the group on SPG were significantly longer than in the control group. In the Stage II patients, there was significant difference in time to recurrence, and survival of SPG group tended to be longer than that of the control group. However, in the Stage III patients, there was no significant difference in either time to recurrence or survival rate.     

进展期胃癌根治术后早期复发的影响因素分析

目的:分析影响进展期胃癌根治术后早期复发的相关因素,为临床干预工作提供依据。方法:选取2009年6月至2012年7月本院收治的195例进展期胃癌患者作为研究对象,所有患者均接受胃癌根治术治疗,根据患者术后1年内复发与否将上述患者分为早期复发组(n=103)与对照组(n=92)。先后采用x2检验、非条件Logistic回归分析确定影响进展期胃癌根治术后早期复发的独立相关因素。结果:单因素分析发现,两组患者的肿瘤直径、Borrmann分型、Lauren分型、T分期、N分期、TNM分期、新辅助化疗、术后化疗等指标相比差异有统计学意义(P0.05),两组患者的性别、年龄、体质指数、肿瘤位置、分化程度、手术方式、腹腔镜手术等指标相比差异无统计学意义(P0.05)。非条件Logistic回归发现,N分期、TNM分期是影响进展期胃癌根治术后早期复发的独立危险因素,而新辅助化疗是独立保护因素。结论:进展期胃癌的N分期、TNM分期是其术后早期复发的独立危险因素,采取而新辅助化疗可降低进展期胃癌根治术后早期复发率。     

Clinical evaluation of sizofiran combined with irradiation in patients with cervical cancer

Following a previous report [1] we ascertained the effectiveness of sizofiran (Schizophyllan:SPG) to prolong the survival and time to recurrence of the patients with Stage II or III cervical cancer, as evaluated in a 5-year randomized controlled study conducted in 19 institutions in Japan. Of the overall patients with Stage II or III cancer, time to recurrence and survival rate in the group on SPG were significantly longer than in the control group. In the Stage II patients, there was significant difference in time to recurrence, and survival of SPG group tended to be longer than that of the control group. However, in the Stage III patients, there was no significant difference in either time to recurrence or survival rate.     

宫颈癌术后复发的危险因素及SCC-Ag、HR-HPV对复发的预测价值分析

目的:分析宫颈癌术后复发的危险因素,探讨鳞状细胞癌抗原(SCC-Ag)、高危型人乳头瘤病毒(HR-HPV)对宫颈癌术后复发的预测价值。方法:对2010年1月至2017年12月我院收治的宫颈癌患者300例进行回顾性分析,收集其临床资料,所有患者随访2年,定期检测SCC-Ag表达情况及HR-HPV感染情况,根据患者复发情况分为复发组与未复发组,应用单因素和多因素Logistic回归分析宫颈癌术后复发的危险因素,以病理诊断为金标准,分析SCC-Ag、HR-HPV对宫颈癌术后复发的预测价值。结果:随访期间出现12例失访,300例患者中完成随访288例,出现复发40例,未复发248例。单因素分析结果显示宫颈癌术后复发与肿瘤直径、分化程度、肿瘤间质浸润情况、临床分期、淋巴结转移、SCC-Ag阳性表达、HR-HPV持续感染有关(P0.05),而与发病年龄、体质量指数(BMI)、吸烟史、性行为开始年龄、宫颈癌家族史、病理类型、术后放化疗无关(P0.05)。多因素Logistic回归分析显示:中低分化、深肌层浸润、临床分期IIA1-IIA2期、有淋巴结转移、SCC-Ag阳性、HR-HPV持续感染是宫颈癌术后复发的危险因素(P0.05)。SCC-Ag联合HR-HPV预测宫颈癌术后复发的灵敏度、特异度、阳性预测值、阴性预测值分别为92.50%、87.50%、54.41%、98.64%。结论:中低分化、深肌层浸润、临床分期IIA1-IIA2期、有淋巴结转移、SCC-Ag阳性、HR-HPV持续感染是宫颈癌术后复发的危险因素,SCC-Ag联合HR-HPV预测宫颈癌术后复发具有一定价值,值得临床关注。     

完整胃系膜切除治疗胃癌的研究进展

目前胃癌的主要治疗方式仍是手术治疗,标准D2根治术已得到推广,但胃癌术后的局部复发仍是导致患者远期预后不佳的重要因素。早期胃癌患者的检出率低和手术淋巴结清扫的不规范及胃周软组织切除的不彻底是导致胃癌患者局部复发的重要因素。全直肠系膜切除(TME)和完整结肠系膜切除(CME)对降低结直肠癌术后局部复发效果明显,相同进展程度下远期预后明显好于胃癌。近年提出的完整胃系膜切除治疗胃癌可能会降低胃癌术后局部复发,改善患者预后,规范了完成胃癌根治术的完整流程标准,对于胃癌手术的规范化实施达到整块切除具有指导意义,随着微创理念不断的深入,腹腔镜的应用与发展使我们对系膜的认识更加深入,我们对完整胃系膜切除治疗胃癌的现状及研究进展进行综述如下。     

吡柔比星预防浅表性膀胱癌术后复发的疗效观察

目的：比较吡柔比星与吉西他滨膀胱内灌注预防浅表性膀胱癌术后复发的疗效。方法：40 例浅表性膀胱癌患者根据随机抽 签法分为治疗组与对照组各20 例,所有患者都采用经尿道膀胱肿瘤电切方法,对照组用吉西他滨,治疗组用吡柔比星进行膀胱 灌注,比较两组患者术后复发率的不同。结果：所有患者都完成治疗,随访1 年,治疗组的复发率为5.0 %,对照组为25.0 %,治疗 组的复发率明显低于对照组,对比差异明显,有统计学意义(P<0.05)。经过观察,治疗组的膀胱刺激症状、骨髓抑制、尿道狭窄等不 良反应总体发生率明显少于对照组,两者比较有统计学意义(P<0.05)。结论：相对于吉西他滨,吡柔比星膀胱内灌注预防浅表性膀 胱癌术后复发有很好的效果,不良反应少,在临床上需要根据患者的实际情况来选择不同的灌注药物。     

术前预后营养指数、全身免疫炎症指数联合血清TFF3对宫颈癌术后复发转移的预测价值

摘要 目的：探讨术前预后营养指数（PNI）、全身免疫炎症指数（SII）联合血清三叶因子3（TFF3）对宫颈癌术后复发转移的预测价值。方法：选取2018年1月～2020年1月在江苏省人民医院行手术治疗的宫颈癌患者176例,随访3年根据是否出现复发转移将宫颈癌患者分为复发转移组（38例）和无复发转移组（138例）。计算术前PNI、SII和检测术前血清TFF3水平。宫颈癌术后复发转移的影响因素采用多因素Logistic回归模型分析,绘制受试者工作特征（ROC）曲线分析PNI、SII、TFF3单独及PNI、SII联合血清TFF3预测宫颈癌术后复发转移的价值。结果：随访3年,176例宫颈癌患者复发转移率为21.59%（38/176）。与无复发转移组比较,复发转移组PNI降低,SII和血清TFF3水平升高（P＜0.05）。多因素Logistic回归分析显示,低分化、国际妇产科联盟（FIGO）分期Ⅱ期、盆腔淋巴结转移、切缘阳性、鳞状细胞癌抗原升高、SII升高、TFF3升高为影响宫颈癌术后复发转移的独立危险因素,PNI升高为独立保护因素（P＜0.05）。ROC曲线分析显示,PNI、SII联合血清TFF3预测宫颈癌术后复发转移的曲线下面积为0.906,大于PNI、SII、TFF3、PNI+SII、PNI+TFF3、SII+TFF3预测的0.795、0.785、0.772、0.860、0.874、0.860。结论：术前PNI降低和SII、血清TFF3水平降低与宫颈癌术后复发转移密切相关,术前PNI、SII联合血清TFF3对宫颈癌术后复发转移的预测价值较高。     

Effect of postoperative intrapleural instillations of interleukin-2 in patients with malignant pleurisy due to lung cancer

Thirteen patients with resectable lung cancer and concomitant malignant pleurisy which could not be detected by preoperative chest roentogenograms were treated with surgical resection of the primary lesions and postoperative intrapleural instillations of interleukin-2 (IL-2). All of the patients demonstrated disappearance of cancer cells from pleural effusion after the IL-2 therapy. Four of the 13 patients survived over 5 years and 2 of them are in disease free state at this moment (January 31, 1993). The first recurrent sites were distant organs in 8 of 11 patients with recurrence and lymph nodes in 3 of them. No pleural recurrence was observed. These results indicate that the postoperative intrapleural IL-2 therapy may be one of hopeful adjuvant therapies in patients with resectable lung cancer and concomitant malignant pleurisy, although distant metastasis and lymph node recurrence could not be suppressed completely.     

Identification of Locally Advanced Rectal Cancer with Low Risk of Local Recurrence

Background

The routine application of neoadjuvant chemoradiotherapy for T3N0 rectal cancer remains controversial. The aim of this study was to use clinical, Magnetic resonance imaging, and pathological parameters to identify a subgroup of patients with low risk of local recurrence who might be precluded from neoadjuvant chemoradiotherapy.

Methods

We retrospectively reviewed a prospectively maintained database of consecutive rectal cancer patients who underwent curative resection. 166 pathologic confirmed T3N0 rectal cancer patients with tumor located 5–12cm above the anal verge and preoperative circumferential resection margin>1mm were included in analysis. The primary outcomes measured were3- and 5-year local recurrence rates.

Results

Local recurrence was demonstrated during follow-up in 5 patients; the actuarial overall 3- and 5-year local recurrence rates were 2.5% and 3.4%, respectively. Inadequate sampling of lymph nodes (≤12) was associated with higher local recurrence (P = 0.03) in this group of patients.

Conclusion

For upper and middle T3N0 rectal cancer with preoperative circumferential resection margin>1mm, local recurrence rate after total mesorectal excision is low and surgery alone may be enough for this group of patients.     

MMP-2、MMP-9及P53的表达在肝移植后肿瘤复发与转移预测中的价值研究

目的：探讨MMP-2、MMP-9及P53的表达在预测肝癌行肝移植后肿瘤复发与转移中的价值。方法：选择肝癌行全肝移植患者85例,应用免疫组化方法检测其切除的肝癌组织中MMP-2、MMP-9及P53的表达,并对患者进行移植术后随访,观察术后肝癌复发与转移情况。分析MMP-2、MMP-9及P53的表达与移植后肝癌复发与转移之间的关系和意义。结果：肝癌组织中MMP-2、MMP-9及P53阳性表达率均明显高于癌旁组织（P〈0.01）。MMP-2表达与肝癌肿瘤直径、TNM分期、病理分级及门静脉癌栓显著相关性（P〈0.05）,MMP-9表达与肝癌肿瘤直径、TNM分期、门静脉癌栓及肿瘤包膜显著相关性（P〈0.05）,P53表达与肝癌肿瘤直径、门静脉癌栓及肿瘤包膜显著相关性（P〈0.05）。MMP-2、MMP-9在未复发和转移组中的表达明显低于复发和转移组（P〈0.05）,而P53在两组间的表达差异无显著性（P〉0.05）。肝癌组织中MMP-2、MMP-9高阳性表达均是预测肝癌患者肝移植后肿瘤复发和转移的独立预见因子,而P53未显示其具有预测意义。结论：MMP-2、MMP-9及P53在肝癌组织中呈高表达,MMP-2、MMP-9的表达水平可以有效预测肝癌患者肝移植后肿瘤复发和转移。     

Socioeconomic status and its relation with breast cancer recurrence and survival in young women in the Netherlands

BackgroundAssociations between socioeconomic status (SES) and breast cancer survival are most pronounced in young patients. We further investigated the relation between SES, subsequent recurrent events and mortality in breast cancer patients < 40 years. Using detailed data on all recurrences that occur between date of diagnosis of the primary tumor and last observation, we provide a unique insight in the prognosis of young breast cancer patients according to SES.MethodsAll women < 40 years diagnosed with primary operated stage I-III breast cancer in 2005 were selected from the nationwide population-based Netherlands Cancer Registry. Data on all recurrences within 10 years from primary tumor diagnosis were collected directly from patient files. Recurrence patterns and absolute risks of recurrence, contralateral breast cancer (CBC) and mortality – accounting for competing risks – were analysed according to SES. Relationships between SES, recurrence patterns and excess mortality were estimated using a multivariable joint model, wherein the association between recurrent events and excess mortality (expected mortality derived from the general population) was included.ResultsWe included 525 patients. The 10-year recurrence risk was lowest in high SES (18.1%), highest in low SES (29.8%). Death and CBC as first events were rare. In high, medium and low SES 13.2%, 15.3% and 19.1% died following a recurrence. Low SES patients had shorter median time intervals between diagnosis, first recurrence and 10-year mortality (2.6 and 2.7 years, respectively) compared to high SES (3.5 and 3.3 years, respectively). In multivariable joint modeling, high SES was significantly related to lower recurrence rates over 10-year follow-up, compared to low SES. A strong association between the recurrent event process and excess mortality was found.ConclusionsHigh SES is associated with lower recurrence risks, less subsequent events and better prognosis after recurrence over 10 years than low SES. Breast cancer risk factors, adjuvant treatment adherence and treatment of recurrence may possibly play a role in this association.     

DNA Methylation Combinations in Adjacent Normal Colon Tissue Predict Cancer Recurrence: Evidence from a Clinical Cohort Study

Accumulating evidence has suggested the requirement for further stratification of patients in the same tumor stage according to molecular factors. We evaluate the combination of cancer stage and DNA methylation status as an indicator of the risk of recurrence and mortality among patients with colorectal cancer (CRC). A cohort study of 215 patients with CRC (mean age 64.32 years; 50.5% of men) from Tri-Service General Hospital in Taiwan examined the association between cancer stage and risk of CRC recurrence and mortality. A Cox proportional hazard model was used to analyze patient methylation status and clinical information at study entry, and their associations with CRC recurrence and mortality during follow-up. The advanced stage patients with p16, hMLH1, and MGMT methylation were associated with higher risk of CRC recurrence compared with the local stage patients with unmethylation status in tumor tissues, with adjusted hazard ratios (HRs) (95% confidence interval [CI]) of 9.64 (2.92–31.81), 8.29 (3.40–20.22), and 11.83 (3.49–40.12), respectively. When analyzing normal tissues, we observed similar risk of CRC recurrence with adjusted HRs (95% CI) of 10.85 (4.06–28.96), 9.04 (3.79–21.54), and 12.61 (4.90–32.44), respectively. For combined analyses, the risk of recurrence in the patients in advanced stage with DNA methylation in both normal and tumor tissues, compared with local stage with unmethylation, was increased with adjusted HR (95% CI) of 9.37 (3.36–26.09). In the advanced stage patients, methylation status and tissue subtype were associated with increased risk of 5-year cumulative CRC recurrence (p < 0.001). This study demonstrates that clustering DNA methylation status according to cancer stage and tissue subtype is critical for the assessment of risk of recurrence in CRC patients and also indicated an underlying mechanism.     

胰腺癌患者循环肿瘤细胞及TLR4、TLR9、myd88的表达水平与其化疗效果及转移、复发的关系

目的:探讨胰腺癌患者循环肿瘤细胞(CTC)中Toll样受体4(TLR4)、Toll样受体9(TLR9)、髓样分化因子88(myd88)的表达水平与患者化疗效果及转移、复发的关系。方法:将我院2015年6月-2016年6月收治并确诊的48例胰腺癌患者作为试验组,收集患者循环肿瘤细胞(CTC),检测其TLR4、TLR9、myd88信号表达情况,探讨其TLR4、TLR9、myd88信号表达水平与患者化疗效果及转移、复发的关系。结果:48例胰腺癌患者检出CTC 35例,检出率为72.9%。胰腺癌死亡、转移、复发患者TLR4、TLR9、myd88表达水平分别高于其存活、未转移、未复发患者,组间具有统计学差异(P0.05)。胰腺癌化疗效果CR患者TLR4、TLR9、myd88表达水平显著低于其化疗效果PR、SD、PD患者,且四组间差异具有统计学意义(P0.05);TLR4、TLR9、myd88表达水平与被膜受侵犯、淋巴结转移、肿瘤大小、CA199水平呈正相关(P0.05)。结论:胰腺癌患者CTC中TLRs/myd88信号表达水平与患者化疗效果及转移、复发密切相关。