Detection And Clinical Significance Of Circulating Tumor Cells In Advanced Gastric Cancer Based On ISET Technology

Objective:To investigate the detection of circulating tumor cells (CTCs) in peripheral blood of patients with advanced gastric cancer, and to explore the relationship between the CTCs and clinical characteristics of them based on ISET technology.Methods:The Kato III cells were used to test the recovery rate and sensitivity of ISET technology; Choosing 34 cases of stage IV gastric cancer patients who were confirmed by pathology during October 2014 to July 2015 as the research object and 15 cases of healthy volunteers as control in Department of Oncology of Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School; After the acquisition of 2.5 ml venous blood from subjects, we used CTCBIOPSY to detect the positive rate of CTCs and analysis the relationship between CTCs and clinical characteristics of patients.Results:The average recovery rate of ISET was 85.5% and the sensitivity was 1/2.5ml. In gastric cancer group, there are a total of 34 patients with stage IV gastric cancer, including 16 cases of female,18 cases of male; 28 cases of adenocarcinoma,1 case of undifferentiated carcinoma,3 cases of signet ring cell carcinoma,1 cases of mucous cell carcinoma and 1 case of low adhesion carcinoma. Liver metastases were found in 17 cases, bone metastasis in 4 cases and abdominal and pelvic metastasis in 24 cases. Circulating tumor cells were detected in peripheral blood of 8 cases of gastric cancer group, the positive rate was 23.5%(8/34), while no circulating tumor cells was detected in 15 cases of control group. In gastric cancer group,4 cases of them with CTCs= 4,4 cases with CTCs=1 and 26 cases with CTCs=0. Average of tumor marker AFP, CA199 and CA242 in group of CTCs≥4 and CTCs=0 was:6484.3 vs 102.9 ng/ml、4595.5 vs 683.8 U/ml、23332.1 vs 806.0 U/ml(respectively), the difference between the two groups has statistical significance (P= 0.021; 0.049; 0.020).Conclusion:CTCs capture technology based on ISET method has a high detection rate, in patients with advanced gastric cancer, the number of CTCs in peripheral blood appeared positive correlation trend with their level of tumor marker, namely the more number of CTCs(CTCs≥4), the higher of their corresponding level of AFP, CA199 and CA242. Because of the small number of samples in this experiment, the conclusion is worthy of further study.