Study Of The Correlation Between Circulating Tumour Cells And The Progression In Colorectal Cancer

ObjectiveThis study aims to analyze the relationship between CTCs and colorectal cancer progression by dynamically detecting circulating tumor cells(CTCs)in patients with colorectal cancer(CRC),and to investigate the value of CTCs in assessing colorectal cancer progression.MethodsClinical and pathological data were collected from 604 CRC patients who underwent surgical treatment at the Second Affiliated Hospital of Nanchang University between May 2019 and August 2022 and had CTCs detected preoperatively.The patients were followed up for postoperative tumor progression and survival.CTCs were detected in 30 patients with progression and 37 patients without progression by negative enrichment combined with immuno-fluorescence in situ hybridization(im-FISH).Results1.95.53%(577/604)of the 604 CRC patients were at follow-up and 4.47%(27/604)were missed;of the 577 patients at follow-up,17.33%(100/577)had progression and 82.67%(477/577)had no signs of tumor progression.604 CRC patients had a significantly higher rate of positive preoperative CTCs in males than in females.The difference was statistically significant(P=0.004),and the difference in the count of preoperative CTCs between men and women was not statistically significant(P=0.062).There was no correlation between the preoperative CTCs positivity rate and count value and patient age,tumor site,tumor size,lymph node metastasis,tumor stage,vascular invasion,nerve invasion,Ki67 index,and microsatellite instability(P>0.05).There were no statistically significant differences in the preoperative CTCs positivity rate,preoperative CTCs count value,and preoperative CTCs high value rate(CTCs count value ≥ 5/3.2 ml)between patients with and without tumor progression at follow-up(P>0.05).2.In the experimental group:there was no statistically significant difference between the preoperative and post-progression CTCs positivity rates of patients with tumor progression(P=0.062);there was no statistically significant difference between the preoperative and postoperative reexamination CTCs positivity rates of patients without tumor progression(P=0.744);there was no statistically significant difference between the preoperative CTCs positivity rate and postoperative reexamination CTCs positivity rate of patients with tumor progression and patients without tumor progression(P>0.05).3.In the experimental group,the median CTCs count in patients with tumor progression was higher than that before surgery,and the difference was statistically significant(P<0.001);the median CTCs count in patients without tumor progression was not significantly different between preoperative and postoperative review(P=0.955).Among the 30 patients with tumor progression,24 patients had higher CTCs after progression than before surgery(80.00%,24/30),and among the 37 patients without tumor progression,13 patients had higher CTCs than before surgery(35.13%,13/37);the progression group was significantly higher than the non-progression group,and the difference was statistically significant(P<0.001).Among the 30 patients with tumor progression,the CTCs counted decreased in 3 cases after progression compared with preoperative values(10.00%,3/30);among the 37 patients without tumor progression,14 cases decreased compared with preoperative values(37.84%,14/37);the non-progression group was significantly higher than the progression group,and the difference was statistically significant(P=0.020).4.In the experimental group:the rate of high values of CTCs after progression in patients with tumor progression was significantly higher than that before surgery,and the difference was statistically significant(P=0.004);the rate of high values of CTCs after progression in patients with tumor progression was significantly higher than that of CTCs in patients without tumor progression on postoperative review,and the difference was statistically significant(P=0.048).5.There was no significant difference in the rate of positive preoperative CTCs between patients who died of tumors and surviving patients(P=0.821);the rate of high values of preoperative CTCs was significantly higher in patients who died of tumors than in surviving patients,and the mortality rate was statistically higher in CRC patients with ≥ 5 preoperative CTCs than in CRC patients with<5 preoperative CTCs(P=0.040).ConclusionPatients with colorectal cancer with tumor progression had significantly higher CTCs count values;the rate of high CTCs count values was significantly higher in the tumor progression group than in the non-progression group;and patients with colorectal cancer with preoperative CTCs count values≥5 had high mortality.