Identifications And Biology Characteristics Of The Circulating Tumor Cells In Peripheral Blood Of Pancreatic Cancer

Metastasis is the leading cause of cancer related death.Most deaths from solid tumors are caused by haematogenous spread of cancer cells into distant organs and their subsequent overt metastases.Recent work suggested that dissemination of primary cancer cells to distant sites might be an early event.The biological characteristics and clinical relevance of circulating tumor cells(CTCs) in solid cancer is still not clearly elucidated.But many literatures reported that CTCs in peripheral blood of solid cancer had a relationship with the poor prognosis and tailored therapy.Few literatures report the biologic characteristics and clinical significance of CTCs in peripheral blood of patients with pancreatic,ampullary cancer by cyotmetric method.We set up immunomagetic negative enrichment together with fluorescence in situ hybridization(FISH) and(Haematoxylin & Eosin) HE to identify CTCs compared with Mitineyi and Xinzhi beads.Moreover,Cell spiking experiment showed the method had about 85%recocvery rate.CTCs would be properly identified CTCs not only the cells with intact structures but also the one with fragmented plasma membrane or nude nucleus.CTCs were detected in 63.2%(55/87) samples of pancreatic cancer patients but not in 18 pancreatic cystic neoplasms patients,7 pancreatitis patients and 25 healthy donors.The rate of detection of CTCs had a relationship with tumor stage,the invasion depth of tumor,lymph node metastasis and the organ metastasis.Patients with CTCs in peripheral blood before treatment predicted a poor prognosis(n=59).The trend persisted in the same AJCC stage.In 14 patients by adjuvant therapy during surgery or after surgery,a different ratio of apoptotic CTCs were found in peripheral blood of pancreatic cancer patients. Moreover,detection of higher ratio of apoptotic CTCs or none CTCs suggests a better prognosis.Detection CTCs in 39 patients after surgery predicted the poor prognosis. One case of patient with periampullary carcinoma was followed up all the time.At the same time,CTCs were monitored in different stage of therapy.CTCs may predict the efficacy of the different therapy and the disease progress,which was in accordance with imaging and make up the the normal level of serum tumor makers of CA19-9 and CA24-2 in this case.CTCs in peripheral blood of patients with solid cancers may predicate the tumor recurrence and metastasis.As the increasing of sensitivity and specificity of enrichment and identification of CTCs,adjuvant therapy may be necessary before tumor relapse and metastasis can be detected by radiography,and monitoring the dynamic CTCs and its molecular spectrum may predict individualized therapy for patients with solid cancers.