基于叶酸受体阳性循环肿瘤细胞术前预测胃肠道恶性肿瘤腹膜转移的新模型：中国回顾性研究

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Gut and Liver Pub Date : 2025-03-05 DOI:10.5009/gnl240462

Dan Li, Can Liu, Renwang Hu

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引用次数: 0

摘要

背景/目的：建立基于叶酸受体阳性循环肿瘤细胞（FR+-CTC）的胃肠道恶性肿瘤腹膜转移术前预测模型，并将该模型应用于临床。方法：回顾性收集术前行FR+-CTC计数的胃肠道恶性肿瘤患者。使用logistic回归模型确定胃肠道恶性肿瘤患者腹膜转移的危险因素。采用R软件中的“pROC”包绘制接受者工作特征曲线，根据确定的危险因素预测这些患者的腹膜转移。采用Spearman相关分析评估FR+-CTC计数与危险因素的关系。结果：396例符合纳入标准的患者最终被纳入研究。FR+-CTC数量、白蛋白水平、总蛋白水平、癌抗原125 （CA-125）水平是影响胃肠道恶性肿瘤腹膜转移的危险因素。FR+-CTC的数量与白蛋白呈显著负相关（R=-0.21）， p+-CTC在腹膜转移、淋巴结转移、血管侵袭、神经侵袭以及T3-4期和III-IV期胃肠道恶性肿瘤患者中显著升高(结论：FR+-CTC可作为胃肠道恶性肿瘤的一种新的生物标志物。基于FR+- ctc的新模型在胃肠癌腹膜转移的术前评估中显示出强大的预测能力。

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A New Model Based on Folate Receptor-Positive Circulating Tumor Cells for the Preoperative Prediction of Peritoneal Metastasis in Gastrointestinal Malignancies: A Retrospective Study in China.

Background/aims: To construct a new model based on folate receptor-positive circulating tumor cells (FR⁺-CTC) for the preoperative prediction of peritoneal metastasis in gastrointestinal malignancies and to apply this model in clinical practice.

Methods: Patients with gastrointestinal malignancies who had undergone preoperative FR⁺-CTC counts were retrospectively collected. Risk factors for peritoneal metastasis in patients with gastrointestinal malignancies were identified using a logistic regression model. The "pROC" package in R software was employed to plot the receiver operating characteristic curve for predicting peritoneal metastasis in these patients based on identified risk factors. Spearman correlation analysis was performed to assess the relationship between FR⁺-CTC counts and risk factors.

Results: A total of 396 patients meeting the inclusion criteria were finally included in the study. The number of FR⁺-CTC, albumin level, total protein level, and cancer antigen 125 (CA-125) level were identified as risk factors affecting peritoneal metastasis in gastrointestinal malignancies. The number of FR⁺-CTC was significantly negatively correlated with albumin (R=-0.21, p<0.001), and total protein levels (R=-0.10, p=0.047), and a positively correlated with CA-125 level (R=0.15, p=0.004). The number of FR⁺-CTCs was significantly higher in patients with peritoneal metastasis, lymph node metastasis, vascular invasion, neural invasion, and in those with stage T3-4 and III-IV gastrointestinal malignancies (p<0.05 for all). The model demonstrated stable predictive capacity, as validated through 10-fold cross-validation.

Conclusions: FR⁺-CTCs can serve as a novel biomarker for gastrointestinal malignancies. A new model based on FR⁺-CTCs demonstrated strong predictive capabilities for the preoperative assessment of peritoneal metastasis in gastrointestinal cancers.

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来源期刊

Gut and Liver 医学-胃肠肝病学

CiteScore

7.50

自引率

8.80%

发文量

119

审稿时长

6-12 weeks

期刊介绍： Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.