| Objective:Circulating tumor cells(CTC)in peripheral blood of patients with bladder cancer were detected to explore the application value of circulating tumor cells in prognosis evaluation of bladder cancer.Methods:In this study,92 patients with bladder cancer were included as the experimental group,including 77 males and 22 females.The age range was38–87 years old,with an average age of 66.1±9.7 years old,and the median age was 64 years old.There were 53 cases of muscle-invasive bladder cancer(MIBC),39 cases of non-muscle-invasive bladder cancer(NMIBC),30 cases of low-grade bladder cancer,and 62 cases of high-grade bladder cancer.22 healthy volunteers were enrolled as the control group,including 12 males and 8 females,aged from 38 to 82 years,with an average age of 65.2±10.9 years,and a median age of 68 years.Differential enrichment-fluorescence immunostaining in situ hybridization was used to detect the content of CTC in peripheral blood of the subjects,and the receiver operating characteristic(ROC)was plotted to determine the cut-off value of CTC,so as to analyze the correlation between CTC and the biological characteristics of bladder cancer.Patients were followed up by telephone once a month,outpatient once three months,and abdominal and pelvic CT once six months for a total of two years.Follow-up ranged from 6to 24 months with an average of 21.8±5.2 months.The survival rates and progression-free survival rates of CTC-reduced group and CTC-unreduced group were calculated and compared.Results:When the cut-off value was taken as 1 CTC/7.5 ml,the sensitivity was91.3%,the specificity was 95.5%,the false positive rate was 4.5%,the false negative rate was 8.7%,and the accuracy was 91.3%.The maximum area under the ROC curve was 0.951(P<0.01).The CTC count in the bladder cancer test group was 91.30%(84/92),and that in the control group was4.50%(1/22).The CTC content in the test group was significantly higher than that in the control group(P<0.01).There were 53 cases of bladder cancer with muscular invasion,52 cases of CTC positive,39 cases of non-muscle invasion,and 32 cases of CTC positive.The positive rates of CTC in the muscular invasion group and the non-muscle invasion group were compared,and the difference was statistically significant(X~2=5.418,P<0.05).There were 62 cases of high-grade bladder cancer,60 cases of CTC positive,30 cases of low-grade bladder cancer and 24 cases of CTC positive.The positive rate of CTC in high-grade group was significantly higher than that in low-grade group(X~2=5.208,P<0.05).Among the 60postoperative patients,there were 37 cases of muscle invasive bladder cancer,37 cases of CTC positive,23 cases of non muscle invasive bladder cancer and 17 cases of CTC positive.The positive rate of CTC in muscle invasive group was higher than that in non invasive group,and the difference was statistically significant(X~2=8.022,P<0.05).There were 41 cases of high grade bladder cancer,40 cases of CTC positive,19 cases of low grade bladder cancer and 14 cases of CTC positive.The positive rate of CTC in high grade group was higher than that in low grade group,and the difference was statistically significant(X~2=5.785,P<0.05).The results of imaging progression-free survival analysis showed that the 24-month imaging progression-free survival rate in the CTC reduction group was 95.83%,and that in the CTC non-reduction group was 75.00%.The 24-month imaging progression-free survival rate in the CTC reduction group was significantly higher than that in the CTC non-reduction group,and the difference was statistically significant(X~2=4.538,P<0.05).The survival analysis results showed that the 24-month survival rate of the CTC-reduced group was95.83%,and that of the CTC-unreduced group was 91.67%.The 24-month survival rate of the CTC-reduced group was higher than that of the CTC-unreduced group,and the difference was not statistically significant(X~2=0.404,P>0.05).There was no significant difference in age,gender and CTC positive rate(P>0.05).There was no significant difference in the positive rate of CTC before and after surgery between single or multiple tumors(P>0.05).Conclusion:The positive rate of peripheral blood CTC in bladder cancer patients was correlated with tumor pathological staging.SE-i FISH technology has high sensitivity and specificity for the detection of CTC in bladder cancer,which can be used for the detection of CTC in peripheral blood of patients with bladder cancer.SE-i FISH technology and CTC play an important role in the disease evaluation and prognosis monitoring of bladder cancer. |
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