Clinical Application Of Circulating Tumor Cells Counts And Sub-type In Patients With Cervical Cancer

Background:Cervical cancer is a disease that seriously threatens women’ health,especially in developing countries.The majority of cancer-related deaths result from metastasis,the process by which cancer cells escape the primary tumor site and enter into the blood circulation in order to disseminate to secondary locations throughout the bcdy,and become circulating tumor cells(CTCs).Circulating tumor cells(CTCs)hold huge potential for both clinical applications and basic research into the management of cancer.The CanpatrolTM CTC system was used to divide circulating tumor cells into three phenotypes according to the epithelial-to-mesenchymal transition(EMT)markers,namely epithelial CTCs,mesenchymal CTCs and mixed CTCs.Some studies have found that CTCs counts and sub-types are related to the prognosis of lung cancer,breast cancer and other diseases.However,there are few studies on the application of CTCS in cervical cancer by using the same detection technology.Objective:To analyze the correlation between circulating tumor cells and the clinical features and prognosis of cervical cancer.Methods:This retrospective study enrolled patients with cervical cancer patients admitted to the Zhujiang Hospital of Southern Medical University from December 2012 to January 2016.CTCs were detected Before,during or after the primary treatments in patients.Based on the epithelial-mesenchymal transition phenotype,the CanpatrolTM CTC system was used to isolate and identify CTCs and their sub-types.The clinical characteristics and survival data of the patients were obtained through medical records,imaging data and follow-up records.We analyzed disease-free survival(DFS)as well as overall survivals(OS)of all patients.We also analyzed the relationship between CTC counts and patient age,disease stage,histological differentiation tumor size,and pathological type.The correlations of CTC counts and CTC phenotypes with clinical features and prognostic value of patients were analyzed at lastResults:A total of 53 patients were enrolled in this study from December 2012 to January 2016.At the time of these data analyses,the median follow-up time was 69 months and the maximum follow-up time was 92 months.CTCs were identified in 49 of 53 patients(92.5%),The number of total CTCs ranged from 0 to 243 cells/5ml blood across all 53 patients,with a median value of 3.The probability of detection of epithelial CTC,mesenchymal CTC,and mixed CTC is 57.6%,48.9%,and 67.4%,respectively.The positive rate of CTCs was not correlated with age,FIGO stage,tumor size and other clinical factors.The positive rate of mesenchymal CTC was correlated with tumor size,and the positive rate of mixed CTC was correlated with age and pathological type of patients.The 5-year DFS and 5-year OS were 71.7%and 79.2%respectively.There were no relationship between Patients with CTC counts and sub-types between DFS and OS(P>0.05).Additionally,there were no relationship between Patients with CTC sub-types between DFS and OS(P>0.05).Conclusion:The CTCs count isolated and identified by the CanpatrolTM CTC system had no correlation with the clinical characteristics of cervical cancer patients,while the mesenchymal CTC and mixed CTC subtypes had correlation with the clinical characteristics.The counts and sub-type of CTCs isolated and identified by the CanpatrolTM CTC system have no correlation with the prognosis of cervical cancer patients.