Perioperative Changes And Clinical Significance Of Peripheral Blood CTC From Patients With Rectal Cancer

Objective: To identify CTCs(circulating tumor cells)of peripheral blood from patients with rectal cancer,and further analyze the correlation of the number of CTCs and the type of CTCs with tumor related index(CEA?AFP),different surgical procedures,Tumor size,pathological stages,Nerve invasion,Cancer embolus of the pulse tube,Recurrence and prognosis.To explore the significance of the changes of CTCs in perioperative patients with rectal cancer.Methods: Collect 22 rectal cancer patients who have never received any treatment before were recruited.All the patients were received operation in the same group from peripheral vascular surgery of the Guangxi Zhuang Autonomous Region people's Hospitalfrom from April 2016 to April 2018.Each of the patient blood was checked for CTCs and CTM at the day of surgery and one week after the surgery.Take 10 ml of blood every time.Use CanPatrol 2 CTCs detection technology to enrichment and classification detection of CTCs and CTM and analyze the results.Results:(1)There was no statistical difference between CTCs,age and sex(P>0.05).(2)For those patients with rectal cancer before surgery,the detected rate of single CTCs is 100% and the detected rate of CTM is 0%? After the surgery,the detected rate of single CTCs is 86.4% and the detected rate of CTM is 0%.The detection rate of CTCs was lower than preoperative.But it does not have statistical significance.Beside,there was no significance because CTM was not detected from peripheral blood of the twenty patients with rectal cancer before and after surgery.(3)There was a significant difference between the number of CTCs cells before operation and the number of CTCS postoperative(P = 0.026,P<0.05).There was no significant difference in the number of other types of CTCs after operation(P > 0.05).There was a significant difference between the number of CTCs cells before operation and the number of CTCS postoperative(P = 0.026,P<0.05).There was no significant difference in the number of other types of CTCs after operation(P > 0.05).The median of CTCs cells in the laparotomy group was 0.5 lower than preoperative.The median CTCs cell number in the laparoscopic group decreased by 2.5 compared with preoperative,but there was no difference between the two groups(P > 0.05).(4)There was relationship between solid tumor size and preoperative CTCs cell number(P<0.05).There was relationship between CTCs number and tumor size mixture(P<0.05).There was no significant correlation between the CTCs and the number of various types of tumor size(P > 0.05).(5)There was a significant difference between Preoperative mixed CTCs number and N(lymph node metastasis)(P<0.05).After the operation there was no significant difference between Preoperative mixed CTCs number and N(lymph node metastasis)(P>0.05),There was no significant correlation between CTCs single cell number,epithelial CTCs number and interstitial CTCs number and T(primary tumor stage),N stage and TNM stage(P>0.05),and the difference was not statistically significant.(6)There was a significant difference between CEA and TNM(P<0.05).The postoperative level of CEA decreased compared with the preoperative level of CEA(P<0.05).But the AFP(AFP)level has no obvious relationship between TNM staging(P>0.05),there was no significant correlation between preoperative CEA level and CTCs(P>0.05).(7)There was no significant difference between CTCs and Ki-67 and the degree of tumor differentiationConclusion(s):(1)Surgery can reduce the number of circulating blood CTCs and reduce tumor load.There is no significant difference between laparotomy group and laparoscopy group,and the number of CTCs after laparoscopic surgery is not increased.(2)CTCs is promising as an adjunct to early screening for rectal cancer,guiding clinical diagnosis and treatment.(3)Preoperative CTCs is related to tumor size and lymph node metastasis.Mixed CTCs is closely related to tumor size and lymph node metastasis.The CTCs has guiding significance for clinical staging.(4)CEA is related to TNM,T and N staging in patients with rectal cancer,and has certain help in guiding clinical staging.CEA has no significant correlation with CTCs,and can be used as two independent factors to guide clinical stages.