| Background:Circulating Tumor Cells(Circulating Tumor Cells,CTCs)is considered to be the main factors of distant metastasis and recurrence of Tumor.CTCs play an important role in cancer diagnosis,prognosis and evaluation of curative effect.The postoperative recurrence and metastasis of colorectal cancer patients are the key factors influencing the prognosis.The change of perioperative CTCs is still lack of systematic study for deal with perioperative colorectal cancer patients for postoperative chemotherapy selection and prognosis of relationship.Measure the change rule of perioperative CTCs can help clinicians to develop a more reasonable treatment measures is one of current hot research topic in the field of CTCs.Purpose:Measure CTCs in different clinical stage of colorectal cancer perioperative patients.Analyze CTCs can be used as auxiliary index of TNM staging and perioperative treatment and prognosis of reference or not.Method:Examines 59 example colorectal cancer patient perioperative CTCs expression using the CTC-Biospy.Reslut:(1)preoperative circulating tumor cell positive rate was 34.7%(17/49),after 48 h circulating tumor cell positive rate was 44.9%(22/49),7 to 14 days after positive rate was 38.78%(19/49).From preoperative to 48 h after surgery and postoperative circulating tumor cells between 7 to 14 days three positive rate is to rise and fall,but the three levels has no significant differences.(2)Preoperative baseline positive rate of CTC are: I 12.5%,II stage 53.3%,III stage 30%,IV stage 33.3%,I stage CTC-positive rate of less than II-IV,but did not reach statistical significance,P=0.237.(3)Preoperative baseline adenocarcinoma of CTC positive rate was 37.8% and the non adenocarcinoma,4 cases of CTC was detected;But they did not reach statistical significance(P = 0.284).After the operation,the positive rate of adenocarcinoma was 48h42.2%,37.8% days after 7-14.After the operation,the positive rate of non adenocarcinoma was 48h75.5%,and the postoperative 7-14 days was 50%.The positive rates of CTC were not statistically difference in different pathological types between 48 h and and 7-14 days after operationin P=1.000(4)The influence of depth of infiltration on the positive rate of CTC:The positive rate of T1+T 2 compared with the baseline level of T3+T4 was 10% and 43.2%,with no significant difference,P =0.116.(5)The preoperative baseline level of high and middle differentiated tumors and poorly differentiated tumors CTCs positive rates were 40%,38.5%,27.3%,there was no significant difference.P=0.779;however,after surgery,poorly differentiated tumor CTCs increased significantly from baseline to 27.3%,increased to 48h63.6% after the operation,the final 7-14 days after CTCs positive rate was 45.5%.(6)The number of circulating tumor cells was not correlated with CEA and CA19-9,and the R values were-0.157 and-0.124(P=0.296 and P=0.417)r;The sensitivity of the detection stage I in patients with colorectal cancer,CTCs(12.5%)and CEA(12.5%)without differences,higher than CA19-9(0%);The sensitivity of the detection stage II colorectal cancer patients,CTCs(47.1%)than the CEA(23.5%)and CA19-9(2.9%).The sensitivity of the detection in patients with stage III colorectal cancer,CTCs(31.8%)and CEA(31.8%),no difference,is higher than CA19-9(22.7%).And the sensitivity of the detection of patients with stage IV colorectal cancer,CTCs(44.4%)is lower than CEA(77.8%),higher than CA19-9(33.3%).(7)Colorectal cancer surgery whether choose Laparoscope for 48 h after surgery and postoperative 1 week positive predictive value of circulating tumor cells had no effect;Different ways of colorectal cancer surgery in 48 h circulating tumor cells were positive.After comparing the two,that line the line right half colon radical Dixon and sigmoid colon treated circulating tumor cells were positive significant differences(P = 0.010 and P = 0.012),higher positive rate of circulating tumor cells,and Miles’ operation,Dixon and sigmoid colon had no significant difference between radical prostatectomy.(8)At the first choice of chemotherapy,the postoperative 7-14 days of circulating tumor cells positive rate of XELOX scheme,FOLFOX6 scheme and no chemotherapy had no significant difference(P=0.96),postoperative chemotherapy was selected in this study did not consider the factor of CTC.Conclusion:1.From preoperative to postoperative 48 h and postoperative between 7 to 14 days three positive predictive value of circulating tumor cells while is to rise and fall,but no significant difference between the three.The positive rate of CTC in 7-14 days after operation was still 38.8%,whether it is worth need further studied.2.The preoperative stage I in patients with stage II circulating tumor cells were positive,prompt colorectal cancer can occur at the early stage.Patients with stage I and stage 7-14 still had a higher CTCs positive rate(50% and 33.3%)after II days.Whether the existence of CTCs should be taken as a reference index for the treatment measures is an important issue that needs to be resolved at present.3.The preoperative and postoperative 48 h,7-14 positive rate of circulating tumor cells and colorectal cancer staging,depth of invasion,lymph node metastasis,distant metastasis,pathological type,differentiation degree did not reach statistical significance,and reason is that the research may have a small sample.From the point of view of the change rate of CTCs positive,the positive rate of I CTC was lower than that of baseline II-IV,postoperative 48 h positive rate of CTCs in the group of patients with poor prognostic factors,III stage group,non adenocarcinoma group,T3+T4 group,lymph node metastasis group and low differentiation group of patients was higher than that of group factors better the corresponding prognosis.However,the positive rate of CTCs 48 h in patients with distant metastasis was lower than that in patients without distant metastasis,and the positive 48 h rate of CTCs was lower in patients with IV.The positive rate of CTCs 48 h after surgery may be related to the prognosis of early and middle stage of colorectal cancer.In this study,we should follow the OS and the DFS of the tumor.4.CTC-Biospy system for the detection of colorectal cancer patients with CTCs results and CEA,CA19-9 results has no correlation.To detect the sensitivity of stage I+II patients with colorectal cancer,CTCs was higher than CEA and CA19-9.The sensitivity,CTCs and CEA,and CA19-9 were not different for stage III+IV,patients with colorectal cancer.CTC can be used as a reference index for early diagnosis of colorectal cancer.5.Circulating tumor cells after surgery for colorectal 48 h positive rates are different.After comparing,CTCs positive rate of the right colon radical prostatectomy is higher than Dixon and sigmoid colon radical prostatectomy.Meils’,Dixon and sigmoid colon radical prostatectomy has no difference.6.The circulating tumor cells positive rate of traditional laparotomy and laparoscopic surgery were no significant difference in postoperative 48 h and 7-14 days level.Laparoscopic compared with the traditional operation,the characteristic of its minimally invasive and can’t reduce the number of circulating tumor cells. |
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