Research On Detection And Clinical Significance Of Circulating Tumour Cells In The Peripheral Circulation Of Patient With Gastric Cancer

Objective The CTC of peripheral blood of the same group of gastric cancer patients were detected and followed up by Cell Search system and CTC-Biopsy system(ISET technology).The detection of CTC in the two methods was compared,and the CTC test results and clinical pathology of gastric cancer patients were further analyzed.The relationship between characteristics and prognosis,and explore the clinical guiding significance of CTC detection in the diagnosis and treatment of gastric cancer patients.Methods Sixty-six newly diagnosed patients with confirmed gastric cancer admitted to the Shandong Cancer Hospital during the period from April to December 2014 were randomly selected as the study subjects.In 2014,22 healthy volunteers were selected as the control group.Subjects signed informed consent and enrolled clinical data prior to enrollment.Subjects received 12.5 ml of fasting blood in the median elbow before the anti-tumor treatment,of which 7.5 ml blood samples were used for Cell Search system testing and 5 ml blood samples were used for CTC-Biopsy system testing.The CTC inspection process is performed in strict accordance with the operating manuals of the CTC-Biopsy system and the Cell Search system.The CTC results are interpreted in double-blind interpretation and then reviewed by a third party to ensure accurate results.The experimental group underwent a 4-year follow-up of patients enrolled in 2014 in2018,and registered patient information such as survival status,recurrence and follow-up treatment,and compiled their progression-free survival(PFS)and overall survival.Survival indicators such as(OS).The experimental data was analyzed using SPSS 19.0 software.In the comparison of the detection rate of CTC and the correlation between CTC detection and clinical pathological conditions of patients,the t-test was used for the two sample mean,and the ratio was compared by ?2 test or Fisher exact probability method.In the part of CTC detection and patient prognosis,the correlation between CTC and prognosis was analyzed by Cox risk regression and K-M survival curve.The difference was statistically significant at P<0.05 in the above analysis.Results1.Test results of peripheral blood CTC in healthy volunteers.Peripheral blood of 22 healthy volunteers were detected by Cell Search system and CTC-Biopsy system,respectively.No CTC were detected.2.Detection results of peripheral blood CTCs in patients with gastric cancer.(1)The Cell Search system detected peripheral blood of 59 patients with gastric cancer.Peripheral blood CTC were detected in 16 patients.The total detection rate was27.12%(16/59).The detection rates of CTC in patients with stage I-IV according to TNM pathological stage were 0.00%(0/9),10.0%(1/10),22.22%(6/27)and 64.29%(9/14);no CTM detected.(2)The peripheral blood of 59 patients with gastric cancer was detected by CTC-Biopsy system.Peripheral blood CTC were detected in 35 patients.The total detection rate was59.32%(35/59).The detection rate of CTC in patients with stage I-IV according to TNM pathological stage was detected.They were 44.44%(4/9),40%(4/10),65.38%(17/26)and71.43%(10/14),respectively,and were detected by CTM.1)The detection rates of the two systems were statistically different(P=0.000),and the Kappa value was 0.179,which was inconsistent.3.Correlation between CTC detection results and clinicopathological features in peripheral blood of patients with gastric cancer.(3)Cell Search system detects CTC: CTC in patients with stage I-II gastric cancer are not related to age,gender,KPS score,lymphocytes,neutrophils,hemoglobin,etc.;CTC and neutral in patients with stage III-IV gastric cancer Granulocytes(P=0.020),hemoglobin(P=0.020),granule ratio(P=0.009),CA199(P=0.049),tumor size(P=0.026),vascular invasion(P=0.007)were correlated.(4)CTC-Biopsy system detection of CTC: CTC in patients with stage I-II gastric cancer were associated with granule ratio(P=0.045)and CA199(P=0.050),and CTC and differentiation levels in patients with stage III-IV gastric cancer(P=0.010)is relevant.CTM was associated with CEA(P=0.004)in patients with stage I-II gastric cancer,and CTM was associated with differentiation level(P=0.030)in patients with stage III-IV gastric cancer.4.Correlation between detection results of peripheral blood CTC and prognosis in patients with gastric cancer.(1)The results of Cell Search system detection of CTC(?3/>3)are related to PFS and OS of patients;.(2)The results of CTC-Biopsy system detection of CTC were not associated with prognostic indicators such as PFS and OS.Conclusion1.The detection rate of CTC in CTC-Biopsy system is higher than that in Cell Search system.The reason why Cell Search system and CTC-Biopsy system detect CTC in peripheral blood of gastric cancer patients is different because the detection principle is different.Cell Search system detects CTC.The reason for the low detection rate needs further study.2.CTM can be detected in peripheral blood of patients with gastric cancer using the CTC-Biopsy system.3.The results of Cell Search system detection of CTC were related to neutrophils,hemoglobin,granule ratio,CA199,tumor size,and vascular invasion.The results of CTC-Biopsy system detection of CTC were related to the ratio of granules and differentiation of CA199.CTM is related to CEA and differentiation levels.It is suggested that the results of CTCs can be used as a useful supplement to the clinical pathological staging of gastric cancer.4.Patients with gastric cancer with CTC count ?3 in Cell Search system have longer PFS and OS than patients with gastric cancer with CTC count >3;CTC-Biopsy system has no correlation with patient prognosis,and may have less sample size.