The Prediction Value Of ISET Method To Enrich Circulating Tumor Cells For Postoperative Recurrence Of Hepatocellular Carcinoma Patients

Objective: To evaluate the predictive value of ISET method in the prediction of postoperative recurrence of hepatocellular carcinoma.Method: A total of 73 patients with hepatocellular carcinoma who underwent radical resection on November 4,2016 to March 31,2018 and were pathologically diagnosed as hepatocellular carcinoma after surgery were collected.The patient's 5mL peripheral blood was collected before surgery,7th day after surgery,1st month after surgery and 2nd month after surgery.Result: The changes in the number of CTCs at each follow-up time and the differences in CTCs between the relapsed group and the non-relapsed group were compared.The results showed that the changes in the median CTCs of preoperative and 7th day after surgery were statistically significant(P=0.002),while the differences in CTCs after post-operation 7th day were not statistically significant.(table 1,figure 1).There were statistically significant differences in the median values of CTCs preoperation,7th day after surgery,1st month after surgery and 2nd month after surgery between the relapsed group and the non-relapsed group(table 2,figure 2).ROC showed that preoperative CTCs=5 was a appropriate predictor of postoperative recurrence(table 4,figure 3).Univariate survival analysis showed that preoperative AFP,portal venous branch tumor thrombi,MVI and preoperative CTCs ?5 were risk factors for postoperative recurrence,among which MVI was an independent risk factor for postoperative recurrence(table 5 and 6).Survival analysis curve showed that the disease-free survival time of the CTCs < 5 group and CTCs ?5 group was 22.9 months and 13.7 months,respectively,and the difference was statistically significant(P=0.002)(figure 4).Conclusion:1.Based on ISET,when the critical value of CTCs =5,it has a best predictive value for postoperative recurrence of liver cancer,with a sensitivity of 76.9%,a specificity of 61.7%,and an AUC of 0.713.ISET method is feasible in the detection of liver cancer.2.Surgical excision of the primary lesion is the direct cause of the decrease in CTCs.Preoperative CTCs ?5 is a risk factor for postoperative recurrence.When CTCs ?5,postoperative disease-free survival time is significantly shortened.3.The high level of postoperative CTCs indicates poor prognosis and the risk of early recurrence.Continuous monitoring of CTCs may contribute to the early detection,diagnosis and treatment of recurrence.