内镜超声引导下细针穿刺胰腺癌门静脉血测定循环肿瘤细胞的临床研究

A clinical study on determination of portal venous circulating tumor cells in patients with pancreatic cancer by endoscopic ultrasonography-guided fine needle aspiration

摘要:

目的 评估内镜超声引导下细针抽吸术（EUS-FNA）胰腺癌门静脉采血检测循环肿瘤细胞（CTCs）的安全性及有效性。方法 该研究为一项前瞻性单中心临床研究，纳入5例胰腺癌患者，行EUS-FNA门静脉采血。以外周血CTCs为对照，采用阴性免疫磁珠联合FISH法和叶酸受体阳性循环肿瘤细胞检测试剂盒检测门静脉血和外周血的CTCs的细胞含量。结果 5例患者EUS-FNA下门静脉采血均成功。1例出现血液凝集，未能进行CTCs检测。4例患者进行检测，3例门静脉血和外周血检测到CTCs。其中门静脉血CTCs细胞含量为（10.5 ± 4.0） FU/3.7 mL，外周血CTCs含量为(11.4 ± 4.2) FU/3.7 mL，两组比较差异无统计学意义（P>0.05）。术中术后无感染、腹腔出血和休克等并发症。结论 内镜超声引导下胰腺癌门静脉血循环肿瘤细胞测定是一项安全可行的方法，可有助于胰腺癌早期转移的预估和治疗方案的选择。

Abstract:

Objective： To evaluate the safety and efficacy of circulating tumor cells（CTCs）measurement in patients with pancreatic cancer by endoscopic ultrasonography-guided fine needle aspiration biopsy ( EUS-FNA). Methods: This prospective, single-center clinical study recruited 5 patients with pancreatic cancer, who underwent EUS-FNA for portal vein blood collection to detect CTCs in portal vein blood and CTCs in peripheral blood as control. CTCs were determined using negative immunomagnetic beads combined with FISH and a folate receptor positive circulating tumor cells detection kit. Results：All five patients underwent EUS-FNA portal vein blood collection successfully. One sample developed blood agglutination and failed to perform CTCs test. Four others were tested, and CTCs in portal vein samples and peripheral blood samples were obtained from 3 patients. The mean CTCs in portal vein blood was 10.5 ± 4.0 FU/3.7 mL, and the mean CTCs in peripheral blood was 11.4 ± 4.2 FU/3.7 mL. There was no significant difference between the two groups (P >0.05). There were no complications such as infection, abdominal bleeding or shock during operation. Conclusion It is a safe and feasible method to collect and determine the CTCs in portal venous blood from patients with pancreatic cancer under EUS, which helps prediction and treatment of early metastasis of pancreatic cancer