| Objective: To investigate the relationship between circulating tumor cells(CTCs)and clinical stage,markers,postoperative recurrence,progression free survival by identifying the total number and classification of CTCs in peripheral blood of patients with gastric cancer.Methods:From November 2016 to August 2017,26 patients pathologically proven gastric cancer in Affiliated Cancer Hospital of Guangxi Medical University were collected.CanPatrolTM CTC-second generation capture technique was used to detect the changes of CTCs in 26 patients with gastric cancer before and after operation.Classification identify is based on epithelial-mesenchymal transition(EMT)theory.10 healthy adults were selected as control group.Results:24 patients of thoes 26 patients with gastric cancer were found to be CTCs positive in peripheral blood before operation,The mean values of the total CTCs,mesenchymal CTCs,epithelial CTCs and biophenotypic CTCs were5(range 1 to 44),1(range 0 to 9),1(range 0 to 12),and 2(range 0 to 42),respectively;and 14 patients were CTCs positive at 1 week after operation.All 10 healthy adults were CTCs negative.The total number of CTCs was correlatedwith T stage and AJCC stage,and the difference was statistically significant(p <0.05),but was not correlated with sex,age,N stage,differentiation degree,CEA and CA199(P > 0.05).biophenotypic CTCs was correlated with differentiation degree,and the difference was statistically significant(p < 0.05),but was not correlated with sex,age,T stage,N stage,AJCC stage,CEA and CA199(P > 0.05).mesenchymal CTCs was correlated with AJCC stage,and the difference was statistically significant(P < 0.05),but was not correlated with sex,age,T stage,N stage,differentiation degree,CEA and CA199(P > 0.05).There was significant difference between mesenchymal CTCs before and after operation(p< 0.05);however,there was no significant difference in the epithelial,biophenotypic and total CTCs before and after operation(P > 0.05).In this study,24 cases were positive,progress in 8 cases,16 cases had no progress by the time of last follow-up.To explore the effect of total number and classification of CTCs on prognosis of patients with gastric cancer,grouped by the mean of total number,epithelial proportion,mesenchymal proportion,and biophenotypic types' proportion,terminal event with progress,Separately make a survival analysis,the prognosis of low biophenotypic type CTCs group was better than high interstitial type group before operation(P < 0.05),and the prognosis of high epithelial type of CTCs was better than low epithelial type before operation(P <0.05).From ROC curve and survival analysis according to the proportion of interstitial type and epithelial type of CTCs:the biophenotypic type rate of CTCs was ?0.42 and the epithelial type rate was ?0.17 can serve as a predictor of postoperative progression.Conclusion: the detection of CTCs in gastric cancer patients has certain clinical significance for the judgement of patient's condition,the evaluation of prognosis and the prediction of postoperative progress. |
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