Detection Of Circulating Tumor Cell Stem Cell Marker CD44 In Gastric Cancer And Its Clinical Significance

Objective This study examined the expression of CD44 in gastric cancer tissues and circulating tumor cells,and explored their relationship with clinicopathological features and prognosis of gastric cancer.It is proved that circulating tumor cells have the characteristics of cancer stem cells and play an important role in tumor recurrence and metastasis..Methods immunohistochemical SABC method was used to detect the expression of CD44 protein in postoperative and adjacent tissues of 58 patients with gastric cancer admitted to the first affiliated hospital of anhui medical university from August 2015 to October 2016.Density gradient centrifugation,immunomagnetic negative enrichment and immunofluorescence in situ hybridization(im-Fish)were used to detect peripheral blood CTCs and CD44(+)CTCs in 58 patients with gastric cancer and 29 healthy volunteers.Telephone follow-up was performed after surgery to understand the recurrence of each surgical patient.The follow-up period ended in February 2018.Results CTCs were detected in 44 of the 58 patients with gastric cancer,the detection rate was(75.86%,44/58),and the average number of CTC tests was(1.93±1.766).Among them,34 patients detected CD44,and the detection rate was(58.6%,34/58),CTCs and CD44 test group were significantly different from the control group(P < 0.001).The analysis showed that CTCs and CD44 were associated with depth of invasion,lymph node metastasis,TNM stage and recurrence(P<0.05),but were not associated with age,gender,tumor size,degree of differentiation,and presence or absence of intravascular tumor thrombus metastasis(P>0.05).At the same time,CD44(+)CTCs were detected in 29 patients with gastric cancer,the detection rate was(50%,29/58),and the average number of detections was(1.16±1.424).The analysis found that CD44(+)CTCs were associated with lymph node metastasis,TNM stage and recurrence(P<0.05),but were not associated with age,gender,tumor size,degree of differentiation,depth of invasion,and presence or absence of intravascular tumor thrombus metastasis(P>0.05).).The median follow-up time of 58 patients with gastric cancer was 20(8-30)months.The mean recurrence time of CTCs positive was shorter than the average recurrence time of CTCs negative(?2=19.024,P<0.001).The average recurrence time of CD44 positive(17.090±5.648 months)was shorter than CD44-negative mean recurrence time(25.330±5.305 months)(?2=27.207,P<0.001);mean recurrence time of CD44(+)CTCs(16.030±5.268 months)was higher than CD44(-)CTCs The mean time to recurrence(21.800±4.601 months)was short(?2=22.978,P<0.001).COX multivariate regression analysis found that only TNM stage and CD44(+)CTCs were independent risk factors for gastric cancer prognosis.Conclusion CD44,CTCs and CD44(+)CTCs are associated with the development of gastric cancer and postoperative recurrence and metastasis.It can predict the recurrence of gastric cancer.It is found that CD44(+)CTCs are more sensitive indicators for gastric cancer recurrence monitoring.CD44(+)CTCs have The characteristics of gastric cancer stem cells may be a new indicator for predicting postoperative recurrence of gastric cancer.