Clinical Significance Of Peripheral Blood Circulating Tumor Cell Detection In Oral Squamous Cell Carcinoma

Objective: To study the relationship between the detection of peripheral blood circulating tumor cells(CTC)and the clinicopathological characteristics of patients with oral squamous cell carcinoma(OSCC)and their clinical significance in the diagnosis of OSCC.Methods: Seventy-two patients with OSCC admitted to the Department of Stomatology,the Fourth Hospital of Hebei Medical University from April 2018 to August 2019 were selected as the experimental group,33 patients with benign oral diseases and 20 healthy volunteers were used as control.Peripheral blood CTC was detected in OSCC patients,benign oral disease patients and healthy volunteers by the immunomagnetic bead particle negative enrichment method combined with immunofluorescence in situ hybridization,and serum Squamous Cell Carcinoma Antigen(SCC)was detected simultaneously.Using SPSS26.0 statistical software,The relationship between CTC detection and clinicopathological characteristics of OSCC patients in each group was analyzed by chi-square/Fisher test.Receiver operating characteristic curve(ROC)curve was drawnusing Med Calc v18.2.1 statistical software,and the sensitivity and specificity of CTC detection for OSCC diagnosis were evaluated.Area under curve(AUC)was used to compare the diagnostic value of CTC serum SCC and CTC combined serum SCC.The difference was statistically significant at P<0.05.Results:1.The detection rate of peripheral blood CTC in OSCC patients was 52.78%,which was not detected in patients with benign oral diseases or healthy volunteers,with statistically significant differences(P <0.05).2.The CTC detection rate of T1-T2 OSCC patients was 40.43%,and that of T3-T4 was 76.00%,showing significant differences(P<0.05).The detection rate of M0 patients was 46.77%,and that of M1 was 90.00%,with significant difference(P<0.05).The detection rate of clinical stage I-II was 36.36%,and that of clinical stage III-IV was 66.67%,with significant difference(P<0.05).CTC detection was independent of gender,age,lymph node metastasis,degree of pathological differentiation,location of disease,growth pattern and serum SCC(P>0.05).3.The ROC curve shows that the AUC for CTC detection is 0.764,and the optimal diagnostic cutoff value is 1/4ml.The sensitivity is 52.78% and thespecificity is 100%.The serum SCC detection AUC is 0.651 and the optimal cutoff value is 2.68ng/ml at that time,the sensitivity was 43.05% and the specificity was 92.45%.There was a significant difference in AUC,sensitivity and specificity between the two(P<0.05).The AUC detected by CTC combined with serum SCC was 0.854,the sensitivity was 76.39%,and the specificity was 94.34%.The difference between AUC and the two tests alone was statistically significant(P<0.05).Conclusions:1.The immunomagnetic bead particle negative enrichment method combined with immunofluorescence in situ hybridization can detect peripheral blood CTC in patients with OSCC,and the detection rate was significantly higher than that of benign oral disease patients and healthy volunteers,suggesting that CTC detection can be used for early screening and screening of OSCC.2.The detection rate of CTC is closely related to the T stage,M stage,and clinical stage of OSCC patients.The later the stage of the tumor is,the higher the detection rate of CTC is,indicating that CTC can be used as an indicator of tumor progression and metastatic risk,and become a supplement to personalized clinical TNM staging.3.CTC,as a biological indicator for the auxiliary diagnosis of OSCC,has better sensitivity and specificity than traditional serological SCC,and the combined application of the two has higher diagnostic accuracy.