Clinical Value Of The Numeration Of Circulating Tumor Cells In Patients With Colorectal Cancer

Objective:Through the detection of CTC,to analyze its value in staging,assessing curative effect of operation,monitoring metastasis and recurrence,and diagnosis.Methods:a)7.5ml peripheral blood was collected from 138 cases of colorectal cancer and 34 healthy controls meeting inclusion criteria.The CTC was enriched by beads packaged Anti-EpCAM anti-bodies,then further fluorescently stained with CK,DAPI and CD45.The CTC(CK+,DAPI+,CD45-)was counted,for analyzing the relationship between CTC positive rate and clinicopathological characteristics of colorectal cancer patients without treatment.b)41 patients of the 138 cases were examined at 7 days after operation to observe the difference of CTC positive rate before and after operation.c)In addition,another cohort of 82 post-operative colorectal cancer patients without any treatment within one month was enrolled in order to observe the relationship between CTC positive rate and recurrence and metastasis.d)34 cases of colorectal benign tumor were examined to analyze the difference of CTC positive rate in three groups.Results:a)The statistically significant association between the positive rate of CTC and N and M stage were found(CTC positive rates in N0,N1,N2 stage were 38.3%,37.9%,and 63.9% respectively,?~2=6.819,P=0.033;M0,M1 stage were 38%,71.1%respectively,?~2=12.074,P=0.001);no association between CTC positive rates and age,gender,primary tumor site,T staging,platelets,cancer embolus,NK cells,regulatory T cell are observed.b)The positive rate of CTC before and after operation was not statistically different(P = 0.581).c)The positive rates of CTC between non-metastasis patients and recurrence and metastasis patients were 51.6 % and 90.0 %,respectively(?~2= 9.365,P=0.002),with statistically significant difference.d)The positive rate of CTC in patients with colorectal cancer,colorectal benign tumor and healthy controls were47.12%,35.3%,and 0% respectively,and the difference was statistically significant(?~2=25.931,P<0.001);further analyzing showed that CTC positive rate in patients with colorectal cancer and colorectal benign tumor were not significant difference(?~2=1.538,P=0.215),the difference in patients with colorectal cancer and healthy control,patients with colorectal benign tumor and healthy control had statistical significance(?~2=25.743,P<0.001;?~2=14.571,P<0.001).Conclusion:CTC detection before treatment may help to assess stages in colorectal cancer patients;CTC detection of 7 days after operation could not be used to observe the curative effect;CTC detection may monitor the recurrence and metastasis in post-operative colorectal cancer patients;Although CTC detection can not diagnose colorectal cancer,it may warn the occurrence of colorectal tumors,and the patient(CTC+)should be regular follow-up observation.