Clinical Research Of Circulating Tumor Cell In Renal Cell Carcinoma

Renal cell carcinoma(RCC)is one of the most common urinary tumors in adults.Surgery is the main treatment for RCC.About 20-30% of the patients of RCC have suffered metastasis when diagnosed.Metastatic renal cell carcinoma(mRCC)leads a poor prognosis and the early prediction and follow-up of metastasis,progression and resistance are still key challenges.In recent years,circulating cells and molecular markers are being applied to predict prognosis and progression of malignant tumors.However,diagnosis of metastasis and progression of RCC still relies on the image examination,specific circulating markers of RCC are urgently need to be explored.Circulating tumor cells(CTCs),which is disseminated by tumor or metastases site,is one of the key circulating tumor markers,and is associated with malignant,survival and reactivity of radiation,targeted and chemotherapy.To confirm the prognostic value of CTCs,we would capture circulating tumor cells of RCC by two membrane surface antigens: CA9 and CD147.The capture was conducted on the platform based on the NanoVelcro microfluidic chip.Then the associations between CTCs,prognostic factors and anatomic characteristics would be analyzed.The predictive significance for recurrence of CTCs combined with anatomic characteristics systems would be also explored.Objective:1.Explore the potential associations between CTCs and prognostic clinic characteristics and prognostic value of CTCs;2.Evaluate the influence of anatomic characteristics on CTCs,and exlpore prognostic value of CTCs combined with anatomic characteristics.Methods: 1.Capture and count circulating tumor cells from RCC patients by the established platform based on the NanoVelcro microfluidic chip;2.Analyze the associations between circulating tumor cells and prognostic clinic characteristics such as symptoms,staging,pathological grading and some serological markers;3.Quantitative tumor's anatomic characteristics by RENAL Nephrometry score and Zhongshan score,and evaluate the effect of tumor's anatomic characteristics on CTCs and postoperative progression.Result: 1.RCC CTCs are associated with T stage,clinical stage,hematuria,anemia,alkaline phosphatase,and neutrophilic leukocytosis,but not related with age,gender,osphyalgia,Fuhrman classification and hypercalcemia,thrombocytosis;2.CTCs are influenced by maximum diameter,maximum diameter within renal parenchyma,and horizontal location of tumor,but not correlated with depth and vertical location;3.Zhongshan score and its Ri parameter are independent prognostic factors for postoperative recurrence of clear-cell renal cell carcinoma.Conclusion: 1.Count of CTCs shows a consistent trend with plenty of prognostic clinic characteristics,indirectly indicating that CTCs could play a prognostic role and the platform based on NanoVelcro microfluidic chip is credible;2.Anatomic characteristics of tumor could affect the count of CTCs and postoperative recurrence,and anatomic classification systems such as Zhongshan score combined with CTCs could assist the prognosis prediction of RCC.