Abstract：Objective: To investigate the number of peripheral blood circulating tumor cells (CTCS) in the selection of laparoscopic radical nephrectomy (RLRN) or open radical nephrectomy (ORN) for renal carcinoma and its relationship with postoperative recurrence and metastasis of renal carcinoma. Methods: A total of 73 patients who underwent radical nephrectomy for renal cell carcinoma (RCC) in the Department of Urology, Affiliated Hospital of Chengde Medical College from October 2018 to April 2020 were enrolled as the research subjects. They were divided into the CTC-positive group and CTC-negative group based on the CTC count (5 cells/3.5ml). Among them, the CTC-positive group included 20 patients who received open radical nephrectomy (ORN) and 19 patients who received robot-assisted laparoscopic radical nephrectomy (RLRN); the CTC-negative group included 18 patients who received ORN and 16 patients who received RLRN. The changes in CTC count at 1 week after surgery were compared between the groups. Meanwhile, all patients in both groups were followed up for 48-66 months, with tumor recurrence and metastasis set as the endpoint events. Results: In the CTC-positive group, regardless of whether patients underwent RLRN or ORN, the CTC level at 1 week after surgery decreased (for ORN, the difference before and after surgery was statistically significant, P<0.01; for RLRN, the difference before and after surgery was not statistically significant, P=0.0761). In the CTC-negative group, the CTC level increased after ORN (the difference before and after surgery was not statistically significant, P=0.1061), while the CTC level increased significantly after RLRN (the difference before and after surgery was statistically significant, P<0.01). The total recurrence and metastasis rate of the CTC-positive group was 64.1% (25/39), which was significantly higher than that of the CTC-negative group (26.4%, 9/34), and the difference was statistically significant (P=0.010). Conclusion: In CTC-positive patients, both surgical methods can reduce the CTC level. In CTC-negative patients, both surgical methods increase the CTC count, but the increase in CTC count after RLRN is more significant than that after ORN, indicating that CTC-negative patients may not be suitable for RLRN. The CTC level has certain potential in the selection and guidance of surgical methods for patients with RCC. At the same time, the CTC-positive group has an increased risk of recurrence and metastasis after surgery, suggesting that for patients with RCC after surgery, the prognosis can be evaluated by monitoring the number of circulating tumor cells (CTCs).
宋殿宾, 王志勇, 李修明, 张晶晶, 迟强, 徐辉, 李红阳, 刘英. 外周血循环肿瘤细胞数目对肾癌手术方式的选择及其与术后复发转移的关系[J]. 河北医学, 2025, 31(10): 1728-1732.
SONG Dianbin, WANG Zhiyong, LI Xiuming, et al. The Relationship between the Number of Circulating Tumor Cells in Peripheral Blood and Postoperative Recurrence and Metastasis of Renal Carcinoma. HeBei Med, 2025, 31(10): 1728-1732.
[1] R L Siegel,K D Miller,H E Fuchs,et al.Cancer statistics,2021[J].CA Cancer Clin,2021,71(1): 7-33. [2] A Vasseur,N Kiavue,F C Bidard,et al.Clinical utility of circulating tumor cells: an update[J].Mol Oncol,2021,15(6): 1647-1666. [3] Yootk.Liquidbiopsy in breast cancer:circulating tumoucells and circulating tumoucells DNA[J].Adv Exp Med Biol,2021,11(87):337-361. [4] 白俊杰,白孟麟,邹本奎,等.CellSearch和CTC-Biopsy系统检测肾细胞癌患者外周血CTCs价值探讨[J].中华肿瘤防治杂志,2022,29(17):1290-1294. [5] Hofmanp.Liquidbiopsy for lung cancer:usefulness of circulating tumor cells and other circulating blood biomarkers[J].Cancer Cytopathol,2021,129(5):341-346. [6] Na JC,Kim JH,Kim SY,et al.Establishment of patient-derived three-dimensional organoid culture in renal cell carcinoma[J].Investig Clin Urol 2020,61(2):216-223. [7] Vidlarova M,Rehulkova A,Stejskal P,et al.Recent advances in methods for circulating tumor cell detection[J].International Journal of Molecular Sciences,2023,24(4):28-33. [8] 刘杰,马彩玲,李小航,等.循环肿瘤细胞与尿路上皮癌患者临床特征之间的关系[J].中国肿瘤外科杂志,2022,14(3):291-295. [9] Song J,Yu J,Dong B,et al.Clinical significance of circulating tumor cells and Ki-67 in renal cell carcinoma[J].World Surg Oncol,2021,19(1): 156-161. [10] 陈涛,李丽,姚启盛,等.循环肿瘤细胞数量变化在预测局限性肾癌术后复发转移中的作用[J].肿瘤防治研究,2020,47(2):112-114. [11] Castello A,Carbone FG,Rossi S,et al.Circulating tumor cells and metabolic parameters in NSCLC patients treated with checkpoint inhibitors[J].Cancers (Basel) 2020,12(2):206-212. [12] Yu H,Ma L,Zhu Y,et al.Significant diagnostic value of circulating tumour cells in colorectal cancer[J].Oncol Lett,2020,20(1):317-325. [13] 刘昕,王志勇,迟强,等.循环肿瘤细胞和循环肿瘤内皮细胞计数对局限性肾癌术后复发转移监测的价值[J].现代肿瘤医学,2022,30(4):663-666.
2025, Vol. 31 
冀公网安备13080202000786号