Detection And Clinical Significance Of Circulating Tumor Cells In Pancreatic Cancer

Objective:The degree of malignancy of pancreatic cancer is high,meanwhile early diagnosis is difficult and the prognosis is extremely poor.At present,surgery is the main method for the treatment of pancreatic cancer,but the metastasis and recurrence of tumor after surgery is still the main cause of poor prognosis.There are researches suggesting that the key to tumor recurrence and metastasis is the early micrometastasis of circulating tumor cells(CTC).To provide help to diagnosis micrometastasis of tumor,our group studied the relevance of the number of CTCs and tumor size,lymph node metastasis,and distant metastasis by examining the CTCs in peripheral blood of patients with pancreatic cancer..Moreover,by further categorizing the number of patients in the CTC,it will be clear about the progression of the disease,the choice of individualized treatment options,and the evaluation of prognosis.Methods: Fifty patients with diagnosed pancreatic cancer from People’s Hospital of Huishan District in Wuxi from October 2012 to December 2015 were slected.Ten healthy volunteers and ten patients with pancreatitis were collected as negative control group.Five venous blood samples were collected in each group.The tumor circulating cells in the peripheral blood of each group were detected by immunomagnetic beads and immunocytochemistry.Immunofluorescent labeling was performed with epidermal adhesion molecule(Ep CAM),and the quantity of circulating cells were observed under fluorescence microscope.Results: 1.Correlation analysis between clinical parameters and CTC in pancreatic cancer patients was taken,and there was no significant relationship between the number of CTC and the age and gender of patients(p>0.05).However,it was significantly correlated with tumor size,distant metastasis,and clinical stage(p<0.05).2.By ROC curve analysis,the number of CTC was not as effective as the early indicators of pancreatic cancer as the classic indicators CA199 and CEA.However,the diagnosis value of advanced stage(III,IV)was higher than the above indicators.3.The ROC curve was used to select the best demarcation point(CTC ≥ 4).The higher numbers of CTC group had significant differences in tumor size,lymph node positive grade,distant metastasis rate,and clinical stage with the lower group.The survival rates of 1-year and 3-year of the higher number CTC group were significantly worse than those of the lower group.Conclusion: The correlation between the number of CTC in pancreatic cancer patients detected by immunomagnetic beads and the tumor size,distant metastasis,and clinical stage can be used as a reference index for disease progression.It can also be used as an indicator to assess the overall prognosis.