| Objective: Evaluate the significance of circulating tumor cells(CTCs)detection in ovarian cancer patients and the relationship between CTCs and clinical features.To determine the clinical value of circulating tumor cells(CTCs)in combination with serum markers and imaging for evaluation of postoperative chemotherapeutic efficacy on ovarian cancer and for predicting recurrence free survival.Methods: CTCs of 30 cases of ovarian cancer patients,and 15 cases of benign ovarian disease and healthy volunteers were detected and calculated by immunomagnetic bead negative enrichment combined fluorescence in situ hybridization(imFISH).The relationship with age,TNM staging of clinical features,ascites,serum tumor markers and recist were analyzed.A total of 88 blood samples were collected pre-treatment and post-treatment.Changes in CTCs were evaluated at specific time points according to the patient’s condition and compared with serology and imaging results.The relationship between CTC and the curative effect for ovarian cancer was analyzed.Progression of the disease was dynamically monitored and the therapeutic effect on the tumor was predicted.Results: CTCs number of patients with ovarian cancer(86.7%)was higher than that of benign disease and healthy volunteers(6.67%)(P<0.05).There was a statistically significant difference between positive detection rate of CTCs in peripheral blood and tumor size,differentiation degree,clinical T and M stage(P<0.05).There was no statistically significant difference between positive detection rate of CTCs in peripheral blood and age,pathological type,tumor location,nature,total stage,ascites(P>0.05).CTCs positive detection rate was associated with the expression level of serum marker HE4 and recist evaluation(P=0.001,r=0.153).In 30 patients with ovarian cancer,the positive rate of CTCs was 60% in Ⅰ-Ⅱ stage(3/5),92.9% in Ⅲ stage(13/14),and90.9% in Ⅳ stage(10/11)the number range of CTCs was 0~ 6 in Ⅰ-Ⅱ stage,1~11 in Ⅲ satge,and1~17 in Ⅳ stage.The higher of the stage,the higher the positive rate of CTCs is.15 patients with ovarian cancer who had been treated with CTCs were selected to compare the CTCs results without any treatment before and after the two-cycle chemotherapy with the evaluation of the efficacy of the tumor.The results showed that the number of CTCs in 7 patients with stable disease(PR)decreased in 3 cases.The number of CTCs in 4 patients with stable disease(SD)decreased in 2 cases,and the number of CTCs in 4 patients with disease progression(PD)increased in 3 cases.The change trend of CTCs is generally consistent with that of SD/PD The numerical fluctuation of multiple detection of CTCs was similar to that of serology and imaging during treatment.Patients with recurrence and metastasis were more likely to develop tetraploid amplification in the detected circulating tumor cells.The recurrence-free survival time in patients with positive CTCs was shorter than that in patients with negative results(p < 0.05).Conclusion: 1.The positive rate of CTCs in patients with ovarian cancer was significantly higherthan that of benign and healthy subjects.2.The positive rate of CTCs was positively correlated with the degree of tumordifferentiation,clinicalT,M stage,and the number of CTCs was positively correlatedwith the level of HE4 expression of tumor markers.3.The higher of the tumor stage,the higher the positive value of CTCs is.4.CTCs combined with tumor markers and imaging evaluation can improve thesensitivity of ovarian cancer response to chemotherapy.CTCs detection can be usedas an effective index for monitoring the curative effect of ovarian cancer.5.The increase of tetraploid number can be used as a predictor of relapse or drugresistance.6.CTCs can predict recurrence-free survival in patients with ovarian cancer. |
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