The Value Of Circulating Tumor Cell In Evaluating The Prognosis Of Oral And Oropharyngeal Squamous Carcinoma

Objective: Through retrospective analysis of circulating tumor cell and oral squamous cell carcinoma(Oral squamous cell carcinoma,OSCC)and oropharyngeal squamous cell carcinoma(Oropharyngeal squamous cell carcinoma,OPSCC)disease free survival(Diseases free survival,DFS),aiming to explore the clinical value of CTC in the survival and prognosis of patients with oral and oropharyngeal squamous cell carcinoma.Methods: A total of 89 cases of OSCC and OPSCC patients who were admitted to the Fourth Hospital of Hebei Medical University from March 2018 to March 2019 and confirmed by pathological diagnosis were selected as the research objects,including 47 patients with OSCC and 42 patients with OPSCC.All patients underwent primary resection,of which 57 patients underwent cervical lymph node dissection,38 patients underwent surgery alone,41 patients underwent surgery combined with radiotherapy,and 10 patients underwent surgery combined with radiochemotherapy.All subjects were tested for peripheral blood CTC by negative enrichment and immuno fluorescence in situ hybridization(im FISH)technology before surgery,and the relationship between CTC and DFS in patients with oral and oropharyngeal squamous carcinoma was analyzed.Statistical analysis was performed using SPSS 26.0 statistical software.Chi-square test was used to analyze the count data,and Spearman rank correlation test was used to analyze the correlation between CTC count and the local recurrence of oral and oropharyngeal squamous carcinoma.Kaplan-Meier method was used to draw the survival curves of patients with oral and oropharyngeal squamous carcinoma.Cox proportional hazard regression model was used to analyze and screen the independent prognostic factors of patients and assess their survival risks.The difference was statistically significant at P<0.05.Results:1.During the follow-up,11 of the 89 patients had local recurrence,with the local recurrence rate of CTC positive patients being 18.75%(9/48)and the local recurrence rate of CTC negative patients being 4.88%(2/41).The difference was significant(P<0.05).2.Among the 89 patients,11 had local recurrence and 78 had no local recurrence.In the CTC group,there were 41 cases in group 0<CTC<2,35 cases in group 2≤CTC<5,13 cases in group CTC≥5,Spearman rank correlation test showed a positive correlation between CTC count and local recurrence rate of oral and oropharyngeal squamous carcinoma(r=0.322,P=0.002).3.Kaplan-meier survival curve showed that CTC positive patients with oral and oropharyngeal squamous carcinoma had adverse DFS,and CTC(P=0.042)and T stage(P=0.017)affected the DFS of OSCC patients,while CTC(P=0.027)and lymph node metastasis(P=0.011)affected the DFS of OPSCC patients.4.Multivariate Cox proportional risk regression analysis showed that CTC(HR=0.050,95%CI:0.003-0.880,P=0.041)and T stage(HR=16.899,95%CI:1.483-192.544,P=0.023)were independent prognostic factors affecting DFS in OSCC patients,CTC(HR=0.046,95%CI:0.003-0.758,P=0.031)and lymph node metastasis(HR=17.969,95%CI:1.636-197.330,P=0.018)were independent prognostic factors affecting DFS in OPSCC patients.Conclusions:1.Patients with CTC positive oral and oropharyngeal squamous carcinoma have a higher local recurrence rate than CTC negative patients.2.The CTC count can predict the risk of local recurrence in patients with oral and oropharyngeal squamous carcinoma.The higher the number of CTC,the higher the risk of local recurrence in patients with oral and oropharyngeal squamous carcinoma.3.CTC is the main factor affecting the prognosis of patients with oral and oropharyngeal squamous cell carcinoma.