Study On The Value Of Using EpCAM Magnetic Beads To Capture Urine Tumor Cells(UTCs) For The Diagnosis And Treatment Of Bladder Cancer

Background Bladder cancer is the tenth most common cancer in the world,more common in men than in women,and is the sixth most common cancer and ninth leading cause of cancer death in men.Bladder cancer cells are of epithelial cell origin and Ep CAM is present on the cell surface.Objective By using anti-Ep CAM magnetic beads to capture circulating tumor cells in the blood and urine tumor cells in bladder cancer patients,and comparing and analyzing the differences in blood circulating tumor cells and urine tumor cell counts,the diagnostic value of anti-Ep CAM magnetic beads to capture urine tumor cells in bladder cancer patients and guiding treatment was explored.Methods(1)Blood samples,urine samples and tissue samples from patients with bladder tumors who were treated in the Department of Urology of the First Clinical Hospital of China Three Gorges University from October 2021 to August 2022 were collected.(2)The blood and urine samples of patients included in the standard are stored at 2～6℃cryogenic and sent to the laboratory within six hours for laboratory testing,the laboratory items are mainly circulating tumor cell count,urine tumor cell count,circulating tumor cells,urine tumor cells and tumor tissue PD-L1 staining,FISH detection.(3)Collect and include patient data: age,urine exfoliation cytology results,postoperative pathological results,and collect appropriate amounts of pathological tissues from some patients during surgery and send them to the laboratory for PD-L1 staining and FISH detection.(4)The results are analyzed using statistical software and whether they are statistically significant.Results(1)The sensitivity of UTCs was higher than that of urinary exfoliative cytology,and the difference was statistically significant(86.6%<32.2,P<0.001),and in patients with high-grade bladder urothelial carcinoma,the sensitivity of UTCs detection was higher than that of CTCs,and the difference was statistically significant(P=0.010).In invasive bladder urothelial carcinoma,the sensitivity of UTCs detection was higher than that of CTCs,and the difference was statistically significant(P=0.036).(2)The median count of UTCs in the high-level group was higher than that of CTCs,and the difference was statistically significant(P=0.002).The median count of UTCs in the infiltrative group was higher than that of CTCs,and the difference was statistically significant(P=0.005).The count of UTCs in the high-level group was higher than that in the low-level group,and the difference was statistically significant(P=0.014).The number of UTCs in the infiltrative group was higher than that in the non-infiltrative group,and the difference was statistically significant(P=0.004).(3)UTCs have high sensitivity and diagnostic significance in the diagnosis of invasive and high-grade bladder urothelial carcinoma(P=0.014/P=0.004).(4)The positive rate of UTCs PDL-1 in patients with high-grade bladder urothelial carcinoma was higher than that in patients with low-grade bladder urothelial carcinoma(P=0.028),the positive rate of UTCs PDL-1 in patients with invasive bladderurothelial carcinoma was higher than that in patients with non-invasive bladder urothelial carcinoma(P=0.044),and the positive rate of CTCs PDL-1 in patients with low-grade urothelial carcinoma was higher than that in patients with low-grade urothelial carcinoma(P=0.017);(5)The positive rate of UTCs FISH in patients with high-grade bladder urothelial carcinoma was higher than that in patients with low-grade bladder urothelial carcinoma(P=0.008),and the positive rate of UTCs FISH detection in patients with invasive bladderurothelial carcinoma was higher than that in patients with non-invasive bladderurothelial carcinoma(P=0.008)Conclusion(1)Compared with traditional urine exfoliative cytology detection,the use of Ep CAM antibody magnetic beads to capture UTCs is more sensitive for the diagnosis of bladder cancer;(2)Through the analysis of UTCs counts in different groups,the larger the UTCs count,the higher the malignancy of bladder cancer in patients;(3)Ep CAM antibody magnetic bead capture UTCs have high sensitivity for the diagnosis of invasive or high-grade bladder cancer;(4)The higher the stage grade of bladder tumors,the higher the positive rate of PD-L1 staining of UTCs and the positive rate of FISH detection;(5)The results of FISH detection results for CTCs,UTCs,and tumor tissues through Gene probe No.7,it was proved that CTCs were homologous to tumor tissue.