| Objective: Circulating Tumor Cells of patients with advanced gastric cancer at different treatment stages were examined in this study to explore the relationship between CTCs and clinicopathological characteristics,the efficacy of neoadjuvant chemotherapy,and the efficacy of surgical treatment.To evaluate whether this method can be used to evaluate the therapeutic effect of advanced gastric cancer patients.Methods: A total of 86 patients who were diagnosed with advanced gastric adenocarcinoma and required preoperative neoadjuvant chemotherapy in the Department of Gastrointestinal Surgery,Qinghai University Affiliated Hospital from September 2019 to mid-October 2021 were retrospectively analyzed.The first CTC test was performed for the enrolled patients before neoadjuvant chemotherapy,and the relationship between the positive rate of CTCs and various clinicopathological data of the patients was observed.The second CTC test was performed on patients who completed 3 cycles of PSOX chemotherapy regimen(paclitaxel + oxaliplatin +tegino),and the relationship between the change of CTCs count before and after chemotherapy and the efficacy of chemotherapy was analyzed.The third CTC test was performed on the 10 th day after surgery to analyze the relationship between the change of CTCs count before and after surgery and the therapeutic effect and the relationship between the positive rate of CTCs and postoperative pathological data.Result:1.A total of 86 patients underwent the first CTC test.In the relationship between the positive rate of CTCs and the general clinicopathological data of the patients,the positive rate of CTCs was correlated with the depth of tumor invasion and clinical TNM stage,with statistically significant differences(P < 0.05).There was no significant difference in correlation with gender,age,tumor location,regional lymph node metastasis,degree of tissue differentiation,tumor markers(CEA,CA199,CA724,CA125),vascular invasion,nerve invasion and HER-2 expression(P >0.05).2.A total of 50 patients completed neoadjuvant chemotherapy and underwent a second CTC test.According to RECIST1.1 evaluation criteria,the efficacy of chemotherapy was divided into effective group(CR+PR+SD)and ineffective group(PD).The total CTCs of effective group after chemotherapy(8.68±7.401)was less than that before chemotherapy(12.22±7.895).The total number of CTCs in the invalid group after chemotherapy(19.89±5.968)was higher than that before chemotherapy(11.22±9.324).In the invalid group,the count of CTCs mixed type after chemotherapy(13.89±7.373)was higher than that before chemotherapy(6.89±6.294),the differences were statistically significant(P < 0.05).3.A total of 32 patients underwent surgical treatment after neoadjuvant chemotherapy,and the third CTC test was performed on the 10 th day after surgery.The total number of CTCs after operation(6.97±5.367)was less than that before operation(11.28±7.730).The epithelial CTCs count after operation(0.84±1.110)was lower than that before operation(2.69±3.217),with statistical significance(P < 0.05).Conclusions:1.CTC detection can provide certain clinical significance for the disease evaluation of patients with advanced gastric cancer.2.CTC detection can provide certain clinical significance for evaluating the efficacy of neoadjuvant chemotherapy and surgical treatment in patients with advanced gastric cancer. |
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