The Role Of Circulating Tumor Cells And Fibrinogen In Evaluating The Prognosis Of Head And Neck Tumors

Objective: To retrospectively analyze the relationship between circulating tumor cells(CTCs)and fibrinogen(FIB)and clinicopathological parameters in head and neck tumors,and to explore the value of CTCs and fibrinogen in the survival and prognosis for patients with head and neck cancer.Methods: A total of 79 patients with stage I-IV diagnosed with head and neck tumors were enrolled in Department of Otolaryngology and Oncology,Our Hospital from October 2014 to May 2018.Among them,64 patients were operated.Fifteen patients were unoperated and 52 patients underwent adjuvant therapy.Blood samples were taken before surgery and before any treatment,CTCs were detected using the CellSearch system,and fibrinogen was detected simultaneously.The patients’ clinical data were recorded in detail,SPSS20.0 was used for statistical data processing,the count data was analyzed by chi-square test;correlation analysis was performed by Spearman correlation analysis;survival analysis was performed by Kaplan-Meier survival curve;Cox was used to analyze statistical variables and head and neck tumor prognosis.;P<0.05 was considered statistically significant.To investigate the relationship between CTCs count or fibrinogen levels and clinical pathological parameters such as age,gender,pathological type,location,smoking,alcohol consumption,T、N stage,tumor stage,etc.Survival information was followed up regularly,with a median length of 16 months.Results: 1.A total of 79 patients,aged 30-85 years,with a median age of 64 years;56 males and 23 females;7 nasal malignant tumors,10 nasopharyngeal malignant tumors,and 19 cases of hypopharyngeal malignant tumors 12 cases of oral malignant tumor,24 cases of laryngeal malignant tumor,7 cases of oropharyngeal malignant tumor;24 cases of CTCs positive,55 cases of CTCs negative,the positive rate was 30.37%;2.The levels of CTCs in 79 patients with head and neck cancer were not associated with gender,age,smoking,alcohol consumption,pathological type,T、N stage,location,TNM stage,or operation(P≥0.05),and were associated with adjuvant treatment(P<0.05);Fibrinogen levels were not correlated with gender,age,smoking,drinking,pathological type,surgery,adjuvant therapy,tumor stage(P≥0.05);Cox regression analysis showed radiotherapy(HR=0.037,95% CI: 0.16-0.71,P<0.05)and fibrinogen levels(HR=2.97,95% CI: 1.41-6.25,P<0.05)were independent factors affecting the prognosis of patients with head and neck cancer;CTCs count was negatively correlated with fibrinogen levels(r=-0.145,P≥0.05);3.Kaplan-Meier survival analysis showed that DFS in patients with CTCs negative in 64 patients with head and neck cancer was slightly longer than those in CTCs positive group(31 months ± 2.8 vs 27 months ± 4.2);Higher DFS in lower FIB group The FIB group was slightly prolonged(35 months ± 2.4 vs 28 months ± 4.3);In the I-II stage,23 patients with CTCs negative group had a slightly longer DFS than the CTCs positive group(34 months ± 2.7 vs 31 months ± 1.2);DFS in the same low FIB group was longer in the FIB group(39 months ± 2.7 vs 19 months ± 6.6);41 patients in the III-IV phase after surgery had a slightly longer DFS than the CTCs negative group(32 months ± 4.3 vs 30 months ± 3.6);s lightly higher in the FIB group than in the low FIB group(30 months ± 4.7 vs 29 months ± 3.1);52 patients with postoperative adjuvant therapy in the CTCs positive group DFS was slightly longer than the CTCs negative group(32 months ± 4.3 vs 31 months ± 3.3);The lower FIB group had a slightly longer DFS group(34 months ± 3.0 vs 27 months ± 4.5),but the differences between the groups were no statistical significance(P≥0.05).Conclusion: Radiotherapy and fibrinogen levels were independent factors influencing the prognosis of patients with head and neck cancer.CTCs were still needed for further exploration in large-scale clinical studies in evaluating the prognostic value of patients with head and neck cancer.