Application Of Cell-search System Detect Circulating Tumor Cells In Patients With Renal Cell Method To Explore

Background and Objective It is now one of the hotspots in the field of clinical oncology to study Circulating Tumor Cell (CTC). Up to now the studies of CTC and its clinical value have focused on breast cancer, prostate cancer and colorectal cancer, in which CTC has been confirmed to concern with progression-free survival(PFS)> overall survival(OS) and monitoring of therapy(MOT). The potential clinical value of CTC includes cancer diagnosis and prediction of clinical stage. Renal cell carcinoma(RCC) is one of the most common malignancies in department of urology. The studies of CTC test in patients with renal cell carcinoma are rare either in home and abroad. In this study, we intend to explore the feasibility of the method testing CTC in patients with renal cell carcinoma by Cell-search System(CSS) which is now the newest and most accurate way internationally, and how to improve it.Method TNM stage Ⅲ and Ⅳ patients with renal cell carcinoma hospitalized in the PUMC urology ward and for further consultation in2012are enrolled in this study. At least7.5ml peripheral blood samples from patients with renal cell carcinoma were collected and saved in special test tube by the temperature of15-30℃. The test has to been done in96hours after the blood sample has been drown. We selected fluorescent anti-CK8/18/19antibodies as CTC makers in renal cell carcinoma patients which are same with the CTC makers with which CTC tests were done by CSS in breast cancer, prostate cancer and colorectal cancer patients. Then the number of CTC was quantitative detected by CSS. The feasibility and detection rate of the method testing CTC in patients with RCC by CSS is to be evaluated, and the improvement of method shall be discussed.Results1.Quantitative test results of CTC in8patients with renal cell carcinoma are negative.2.Quite many CK+CD45+"double positive cells" were found in one patient’s peripheral blood.3.The detection rate of CTC has no difference between TNM stage Ⅲ and Ⅳ patients.Conclusionl.The detection rate of the method which tests CTC in TNM stage Ⅲ and Ⅳ renal cell carcinoma patients using CSS with epithelial tumor cell maker anti-CK8/18/19is zero, and the way is unworkable.2.The antigens vary when CTCs in renal cell carcinoma patients enter peripheral blood circulation, for example, CK8/18/19expression comes to a low level, even Ck8/18/19are not expressed or the tumor cells express new cell makers.3.Different types of cancer cells express different cell makers,so anti-CK8/18/19 antibodies can not be used as cell makers in all epithelial cell cancer.4.New renal carcinoma CTC makers shall be searched which are different from traditional epithelial tumor cell makers anti-CK8/18/19antibodies since the method using traditional tumor cell maker is not practical.