项目来源

国家重点研发计划(NKRD)

项目主持人

李杰

项目受资助机构

山东省千佛山医院

立项年度

2016

立项时间

未公开

项目编号

2016YFC0106004

研究期限

未知 / 未知

项目级别

国家级

受资助金额

729.00万元

学科

数字诊疗装备研发

学科代码

未公开

基金类别

未公开

关键词

循环肿瘤细胞 ; 肝细胞癌 ; TACE ; 微血管侵犯 ; Circulating Tumor Cells ; Hepatocellular carcinoma ; MVI

参与者

修鹏

参与机构

未公开

项目标书摘要：肝细胞癌的死亡率在常见恶性肿瘤中排第三位，肝癌术后早期容易发生侵袭和转移，这是肝癌患者5年生存率无法提高的原因之一。目前肝癌根治性切除术后是否需要行辅助性介入治疗尚存在争议，在确定治疗指证时缺乏有效的检测指标，是否可通过CTCs检测评估肝癌微血管侵犯程度以影响术中、术后的治疗策略，为根治性切除术后辅助性介入治疗提供指证具有非常重要的科学意义。本研究选取根治性切除术后病理证实为肝细胞癌的患者设计双中心队列观察试验，在规范化治疗方案的指导下，于不同治疗节点检测CTCs,评价CTCs阳性与微血管侵犯的相关性；根据目前现有的TACE治疗指证，对根治性切除术后部分患者行TACE治疗，以患者无瘤生存期和AFP出现变化为研究终点，以评价CTCs检测指导不同微血管侵犯患者行TACE治疗的指证。研究结果表明:MVI和术前外周血CTCs阳性是HCC根治性切除术后早期复发的独立危险因素，术前外周血CTCs具有MVI预测的潜在价值；术前、术后1周外周血CTCs检测可指导术后预防性TACE治疗。本研究对肝癌领域中循环肿瘤细胞检测的应用产生重要的推广意义，由于CTCs检测与肝癌早期诊断、临床分期及微血管侵犯、肝癌早期复发及预后、肝癌个体化治疗等多个方面的应用有重要的相关性，将目前CTCs检测的流程和方法标准化，规范其在肝癌检测中的应用范围，一方面能够对患者的诊疗提供依据，另一方面也有望影响肝癌患者治疗策略，节省患者的住院费用，从而对整个肝癌领域的研究产生重要的推动意义。

Application Abstract: Hepatocellular carcinoma is the third leading cause of cancer death worldwide.It is difficult to improve the 5-year survival rate of liver cancer patients after surgical treatment,which is mainly attributed to easy invasion and metastasis.Currently,it is still controversial whether there is a need for adjuvant interventional therapy after radical liver resection and there are no effective parameters in determining the indication.Therefore,CTCs detection is of great scientific significance to assess the degree of microvascular invasion and provide evidence for adjuvant postoperative therapy.In this study,patients with hepatocellular carcinoma were selected(confirmed by pathological examinations);clinical controlled trial under the guidance of standardized treatment were carried out.The correlation between positive CTCs and microvascular invasion was evaluated in this study.According to the current indications of TACE,tumor-free survival and AFP changes were the end points,evaluating the indications of CTC-test.The results showed that preoperative peripheral CTCs is a potential MVI predictor;postoperative prophylactic TACE significantly reduced the risk of early recurrence;CTCs test about one week before and after surgery may indicated prophylactic TACE.MVI and positive CTCs were independent risk factors for early recurrence.This study has important significance for the application of CTC detection.Correlation between CTC test results and early diagnosis,clinical stage,microvascular invasion,early postoperative recurrence,prognosis,and individualized treatment of liver cancer prompted us to standardize the current detection process and methods.On one hand,this program can provide evidence for patients'diagnosis and treatment;on the other hand,it is expected to affect the treatment strategy of liver cancer patients,reducing patients'expenses.Therefore,it has an important promoting effect for the research of the whole liver cancer field.

项目受资助省

山东省