Clinical Research Of Circulating Tumor Cells And Ki-67 In Patients With Renal Cell Carcinoma

Background and ObjectiveRenal cell carcinoma(RCC)is a common malignant tumor of the genitourinary system.Transcirculatory metastasis is the most important pathway for the formation of RCC metastasis foci.Circulating tumor cells(CTCs)are defined as tumor cells shedding from the primary tumor site or metastases into the peripheral blood.They may attach to and grow in distant organs and have long been considered a marker of tumor invasiveness.The detection of CTCs provides a new powerful tool to evaluate tumor load and invasiveness.In this study,we analyzed the potential value of metastasis-related biomarkers,circulating tumor cells and the proliferative maker Ki-67 in the diagnosis and treatment of RCC.Patients and MethodsA total of 41 patients with RCC who had received resection at The Affiliated Cancer Hospital of Zhengzhou University between January 2018 and December 2018 were enrolled in this study.24 patients received laparoscopic radical nephrectomy(LRN)and 17 patients received laparoscopic partial nephrectomy(LPN).The numbers and positive rates of CTCs in the peripheral blood of RCC patients were obtained at three different time points: just before surgery,immediately after surgery and 1 week after surgery.The expression of Ki-67 protein was evaluated in RCC tissue by immunohistochemistry(IHC).ResultsThere was no significant difference in age,gender,tumor location,surgical method,pathological type and other general baseline indicators among the 41 patients finally included(P>0.05).Except for the statistically significant association between the preoperative CTC counts and tumor size(P < 0.05),no association between the number and positive rate of perioperative CTCs and clinicopathological features was found,.The CTC counts gradually decreased during the perioperative period,and at 1week after surgery,they were significantly lower than those before surgery(P < 0.05).High Ki-67 expression was significantly positively correlated with preoperative CTC counts(P < 0.05).In addition,high Ki-67 expression was higher in high CTC group(≥ 5 CTCs)(P < 0.05).Conclusions1.Surgical nephrectomy is associated with a decrease in CTC counts in RCC patients.2.CTCs can act as a potential biomarker for the diagnosis of RCC.3.Careful and sufficient long-term follow-up is needed for patients with high preoperative CTC counts.