| Background and Objectives:Oral and maxillofacial malignancy is one of the most common malignancies in clinical practice,90%of which are squamous cell carcinoma,with more than 600,000 cases per case worldwide.It is common in the tongue,cheek,gums,jaw bone,salivary glands and other important anatomical parts,seriously affecting the physiological function and life safety of patients.Oral Squamous Cell Carcinoma(OSCC)has a strong invasive ability,due to the head and neck lymphatic circulation and blood transport is relatively rich,more prone to early lymph node metastasis,some patients have blood metastasis.Although oral squamous cell carcinoma is relatively easy to detect,there are still many cases of OSCC that are not diagnosed until the middle and late clinical stages,missing the best time for treatment and resulting in poor prognosis.At present,common preoperative clinical detection methods are still difficult to detect subclinical tumor lesions.Therefore,it is an urgent need to find a more convenient and effective detection method and clinical evaluation index.Tumor abnormal protein(TAP),also known as Tumor abnormal glycoprotein,is a general name of the glycoproteins with common characteristics produced in the development of various malignant tumors,and plays an important role in the development and metastasis of tumors.Circulating tumor cells(CTCs)are transient precursor cells derived from their own tumor tissues that share the same genetic information and are prone to distant metastasis.They have a high specificity for the identification and characterization of tumors.Recently,with the progressive development of detection technology,the significance of TAP and CTCs in the diagnosis,efficacy and prognosis prediction of patients with malignant tumor has been paid more and more attention.This study proposed respectively agglutination method was applied to detect and negative enrichment and targeted PCR detection technology,detection of OSCC patients and normal control group of peripheral blood TAP and CTCs value,analysis with the tumor pathologic stage,pathological subtype,lymph node metastasis,differentiation,clinical stage,and so the relationship between clinical pathological features,explore the TAP and CTCs detection value and application prospect.Materials and Methods:1.Clinical data:A total of 93 patients with OSCC diagnosed in the First Affiliated Hospital of Zhengzhou University all from May 2019 to May 2020 were chosen as the experimental group,and 20 healthy individual were selected as the control group during the same time.In the experimental group,there were 64 males(68.8%)and 29 females(31.2%),aged from 25 to 78 years old,with an average age of(51.50 ± 12.53)years old.There were 9 males(45%)and 11 females(55%),ranging in age from 22 to 69 years,with an average age of(44.60±12.66)years,In the control group.Inclusion standard:1.Squamous cell carcinoma diagnosed by pathology;2.No primary malignant tumor or serious systemic disease in other sites except OSCC;3.Without undergo radiotherapy,chemotherapy as well as surgery and other related treatments were received before admission;4.Complete medical record clinicopathologic data.Exclusion standard:1.Have been recepted radiotherapy,chemotherapy,surgery and any other treatments befoer.2.Severe infection or severe abnormal liver and kidney function.3.Those who cannot take care of themselves or cooperate with treatment.2.Methods:The TAP values of peripheral blood of the control group and OSCC patients were detected by agglutination test technology.The fingertip blood of the patient was taken under the state of early of the morning.The blood collection standards were strictly followed and the TAP detection was strictly in accordance with the standardized operation.Negative enrichment and targeted PCR were used to detect CTCs values in peripheral blood of patients in the OSCC group and the control group.Blood collection standards were strictly followed.3ml of venous blood was taken from the patient.Blood collection standards were strictly followed during blood collection,and CTCs detection was conducted in strict accordance with standardized procedures.SPSS 23.0 statistical software was used for data analysis.One-way analysis of variance was used for counting data.LSD method was used for comparison between multiple data groups.Receivers operating curve(ROC)was used to analyze the diagnostic value of TAP and CTCs in peripheral blood for OSCC and lymph node metastasis,and Yoden index was calculated based on its sensitivity and specificity.P<0.05 was considered statistically significant.Results:TAP value in experimental group was more advanced than that in control group,and the discrepancy was statistically significant(P<0.001).The TAP value of peripheral blood in the experimental group was not related to sex,age,pathogenic position of disease,T stage and whether there was peripheral tissue infiltration etc(P>0.05).It was related to the N stage(P=0.001),distant metastasis(P=0.021),clinical TNM stage(P=0.038),preliminary and andvanced stage(P=0.013),level of tumor differentiation(P=0.037)and cervical node metastasis etc(P=0.001).The AUC value of TAP for OSCC diagnosis was 0.909,and the energy efficiency test was statistically significant(P<0.05,95%CI was 0.856～0.962).When TAP value was 133.464 μm2,the Youden index was0.728,the sensitivity were 82.8%and specificity were 100%of OSCC.The AUC value of TAP was 0.725 in the diagnosis of OSCC cervical node metastasis,and the power of test was statistically significant(P<0.05,95%CI 0.620-0.830).When the CTCs value was 154.115 μm2,the Youden index was 0.426,the sensitivity was 85.7%,and the specificity was 56.9%.The CTCs value in peripheral blood of experimental group was significantly higher than that of control group(P<0.001);It was not related to the gender of the patient and the location of the disease(P>0.05).but was related to the age,TNM stage,distant metastasis(P=0.013),early and late clinical stage,the degree of tumor differentiation,lymph node metastasis and the presence of surrounding tissue invasion etc(P<0.05).The AUC values of CTCs in the diagnosis of OSCC and lymph node metastasis were 0.925 and 0.679,and the energy efficiency was statistically significant(P<0.05),when the CTCs value was 8.45FU/3ml,the maximum Yoden index was 0.853,and the sensitivity and specificity of OSCC were 90.3%and 95.0%.When the CTCs value was 12.25FU/3ml,the maximum Youden index was 0.367.The sensitivity and specificity of lymph node metastasis were 67.9%and 72.3%respectively.Conclusion:The detection of peripheral circulation tumor abnormal protein(TAP)and circulating tumor cells(CTCs)has vital clinical value for early screening,auxiliary diagnosis,appraisal of metastasis,and judgment of malignant degree,progression and pathological grade of tumor,The combination of the two can improve accuracy. |
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