Clinical Application Of CTCs In The Evaluation Of Cancer Metastasis And Prognosis Of Bladder

[Objective]To detect peripheral blood circulating tumor cells and their types in non muscle-invasive bladder cancer and muscle-invasive bladder cancer patients,and discusses the value of bladder cancer TNM classification and prognostic evaluation in clinical applications.[Method]For eligible patients from 41 cases underwent laparoscopic radical or transurethral resection of bladder cancer in Department of Urology,Second Affiliated Hospital of Kunming Medical University,using CanPatrolTM generation two CTCs detection technology to detect peripheral blood in CTCs.The patients’ age ranges from 33 to 83 years old,37 males and 4 females.For the results of TNM stage of tumor classifications,there were 15 cases in T1 stage,12 cases in stage T2,9 cases in T3 stage,5 cases in T4 stage,6 cases in N1 stage,and 3 cases in M1 stage.The pathological grades of tumor were classified as 30 cases of advanced bladder cancer and 11 cases of low-grade bladder cancer.[Result]In 41 cases of bladder cancer,the positive rate of total CTCs was 68.29%(28/41),2 cases were CTCs positive in 6 cases of lymph node metastasis,and 1 case were CTCs positive in 3 cases with distant metastasis.20 cases of CTCs were detected from 30 cases of high grade bladder cancer accounting for a total of 66.7%,and 7 cases of CTCs were detected in 11 cases of low grade bladder cancer which account for a total of 63.6%.Of 13 patients that are CTCs negative,10 patients were diagnosed without lymph node metastases(69.23%),and 3 patients with lymph node metastasis(30.76%).In high risk(G3)patients group of diagnosing with NMIBC,the positive rate of interstitial CTCs type was 60%,and the positive rate in total number of aged patients whose CTCs are equal or over 3 are 60%;the middle risk patients(G2)group of diagnosing with NMIBC,the positive rate of patients with interstitial CTCs type was 20%,and the positive rate in total number of aged patients whose CTCs are equal or over 3 were 20%.29 patients were followed up with continuous diagnosis in 12-41 months,with an average of 14 plus or minus 2 months,during which there were 8 fatalities in total,concluding the overall survival rate of 72.41%,in which also concludes the survival rate of 77.77%with CTCs positive(14/18),and 63.6%with CTCs negative(7/11).[Conclusion]1.Significant evidence are shown that the total positive rate of interstitial CTCs type as well as the rating of CTCs which are equal or over 3 from high risk(G3)patients group with NMIBC are higher than that from the group of middle risk(G2)patients.2.The total number of CTCs and the number of interstitial CTCs types can be used as factors of prognosticating malignant bladder cancer to some extent so as to determine the early treatment of the patients with NMIBC.3.There are no significant correlations found among CTCs positive rate and bladder cancer TNM stage,lymph node metastasis,and the recent survival rate.