| Objective: through the detection of circulating tumor cells(CTCs)in peripheral blood of elderly patients with prostate cancer,combined with the outcome of clinical biological characteristics,the analysis of meaning of CTCs monitoring in early diagnosis of prostate cancer,therapeutic effect evaluation,early detection of recurrence and prognosis was performed.Methods: We analyzed CTCs counts by using the CellSearch platform in 112 patients(mean age 81.2 ±5 years)from Department of geriatrics and Department of Urology at the First Affiliated Hospital of Soochow University from July 2014 to December 2016?112 cases were collected from patients,including 71 cases of prostate cancer and 41 cases of control group,Among the 71 cases of prostate cancer examples,there were 23 cases positive in according with positive diagnostic criteria as the presence of 5 or more circulating tumor cells in 7.5 ml blood?There were 19 cases of less than 75 years old and 52 cases were more than 75 years old?Collected their peripheral blood specimens,using Cell Search system on the CTCs counting,and recorded their age,hemoglobin(HB),platelet(PLT),prothrombin time(PT),prothrombin time(APTT),fibrinogen(FIB),D-2 dimer(D-D),albumin(ALB),alkaline phosphatase(AKP),lactate dehydrogenase(LDH),prostate specific antigen(PSA)and prostate magnetic resonance,bone scan and abdominal CT results.SPSS 22.0 software package was used to analyze the correlation between the number of CTCs and the above indexes.Results: Among the 71 cases of prostate cancer examples,there were 23 cases positive in according with positive diagnostic criteria as the presence of 5 or more circulating tumor cells in 7.5 ml blood according to domestic and overseas literature and 48 cases negative.Prostate magnetic resonance imaging was used to diagnosis of recurrence,bone scan diagnosis was used to diagnosis of bone metastases,abdominal CT diagnosis of abdominal lymph was used to diagnosis of node enlargement or visceral metastasis,the three cases of prostate cancer were regarded as a result of recurrence and metastasis.Among the 48 negative cases,CTCs were between 1-5 in 27 negative cases,CTCs were suspicious in 5 cases,CTCs were 0 in 16 cases;Among the 71 cases of prostate cancer examples,there were 38 cases with recurrence and metastasis,No recurrence and metastasis were found in 33 cases.CTCs were all negative in 41 cases of the control group.1.The level of CTCs in prostate cancer patients had no relevance with age(P<0.05),but was associated with tumor metastasis(P<0.05),which was of a certain diagnostic predictive value.2.The level of PSA in CTC positive group were higher than negative group,the difference was statistically significant(P < 0.05).3.The level of CTCs of transfer group was higher than the control group,CTCs was associated with distant metastasis,which was statistically significant(P < 0.05).4.The levels of TB,PT,APTT,LDH and AKP Between the two groups were no statistical different(P > 0.05).5.The levels of PLT and FIB,D-D,AKP were higher in prostate cancer patients with recurrence and metastasis and CTCs positive than in patients without recurrence and metastasis and CTCs negative,and the difference was statistically significant(P<0.05).There was no significant difference in ALB,PT,APTT and LDH between the two groups(P > 0.05).6.According to dynamic observation of 9 cases of prostate cancer patients,CTCs levels increased in patients with recurrence and metastasis,whose prognosis were poor.CTCs were negative in patients with no recurrence and metastasis.Conclusions:1.The level of CTCs is associated with evolution and metastasis in prostate tumor,which has a certain diagnostic value.2.The level of CTCs is correlated with PSA,HB,PLT,FIB,D-D and AKP in prostate cancer patients,which can be used as an indicator of disease progression.3.the dynamic change of CTCs level can predict the risk of disease progression,which is of great significance in the treatment of prostate tumor patients. |
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