| Objective:By reviewing the clinical case data of patients with salivary gland malignant tumors,the correlation between the detection of circulating tumor cells(CTC)in peripheral blood and the histological type and aggressiveness of salivary gland malignant tumors was analyzed,and CTC and salivary The relationship between the biological characteristics of adeno malignant tumors provides a basis for the clinical application of CTC detection in evaluating the prognosis of tumors.Method:A total of 116 patients with malignant tumors of salivary glands admitted to the Department of Stomatology,the Fourth Hospital of Hebei Medical University from February 2018 to September 2019 were selected as the research subjects.35 patients with benign tumors of salivary glands and 20 healthy volunteers were used as controls.The immunomagnetic bead particle method combined with immunofluorescence in situ hybridization was used to detect CTC in peripheral blood,and the detection rate was compared between the three groups.Forty-three patients who underwent surgical treatment and were immunohistochemically tested after operation were selected.SPSS26.0 statistical software was used in combination with clinical data to analyze the detection rate of CTC and tumor type and tumor tissue Ki67,CK5 / 6 The relationship between the positive expression of CK7 and P63.Receiver operating characteristic curve(ROC curve)was used to analyze the accuracy of CTC detection in salivary gland tumor cell capture.The Spearman rank sum test was used to analyze the correlation between CTC detection and Ki67,CK5 / 6,CK7,P63 expression,and the difference was statistically significant with P <0.05.Results:1.The detection rates of 116 cases of malignant tumors of salivary glands,35 cases of benign tumors of salivary glands and 20 healthy volunteers were 63.8%,22.8% and 0,respectively.The comparison of the three was P <0.05,which was statistically significant.2.Among 116 cases of malignant tumors of salivary glands,the detection rate of CTC in patients with pleomorphic adenoma,salivary duct carcinoma,mucoepidermoid carcinoma,myoepithelial carcinoma,acinar cell carcinoma,and adenoid cystic carcinoma were 75 %,66.7%,65.7%,62.5%,61.5% and 59.3%.The ROC curve shows that the cancer is in pleomorphic adenoma,mucinous epidermoid carcinoma and adenoid cystic carcinoma.The values below the curve(AUC)are 0.751,0.697,and 0.648;the Yoden index is 0.396,0.303,0.250,and P The values were all <0.05,and the differences were statistically significant.The salivary ductal carcinoma,myoepithelial carcinoma,and acinar cell carcinoma were under curve(AUC)values of 0.715,0.702,and 0.649,and the Youden indices were 0.333,0.375,and 0.333,respectively,and the P values were all> 0.05,with no significant difference.3.The positive expression rates of Ki67,CK5 / 6,CK7 and P63 in the immunohistochemical results of 43 salivary gland malignant tumors were 95.3%,79.1%,72.1% and 67.4% respectively;16 cases of salivary gland benign tumor tissue immunohistochemistry The positive expression rates of ki67,CK5 / 6,CK7 and P63 were 50%,50%,25% and 37.5%,respectively.Spearman correlation analysis showed that: r = 0.537,P <0.001 between CTC detection and Ki67 positive expression rate;r = 0.271,P = 0.038 between CTC detection and P63 positive expression rate;CTC detection and CK7 positive expression R = 0.358,P = 0.005 between rates;r = 0.344,P = 0.008 between CTC detection and CK5 / 6 positive expression rate,all were positively correlated,and the differences were statistically significant(all P values <0.05).4.The positive expression rates of CK5 / 6,P63,Ki67,and CK7 in pleomorphic adenoma were 100%,83.3%,83.3%,and 83.3%,respectively.The results of Fisher's exact probability method and Spearman correlation analysis showed: CTC detection The difference between the positive rates of CK7 and CK7 was statistically significant(P = 0.011),and there was a positive correlation between the two(r = 0.528,P = 0.023);Ki67,P63,CK7 and CK5 / 6 positive in adenoid cystic carcinoma The detection rates were 90.9%,90.9%,81.8%,and 81.8%,respectively.The difference between the positive expression rates of CTC detection and Ki67,P63,and CK7 was statistically significant(all P values were <0.05),and The positive expressions of the three were positively correlated(all P values <0.05);the positive detection rates of Ki67,P63,CK7 and CK5 / 6 in mucoepidermoid carcinoma were 92.9%,57.1%,50.0% and 57.1%,respectively.The difference between the positive rate of Ki67 and Ki67 was statistically significant(P = 0.009),and there was a positive correlation between the two(r = 0.467,P = 0.017).Conclusion:1.Immunomagnetic bead particle method combined with immunofluorescence primary hybridization method can effectively capture the CTC present in the peripheral blood of patients with salivary gland malignant tumors,helping to predict the invasive risk of tumors.2.In salivary gland malignant tumors,the detection rate of peripheral blood CTC is from high to low in order of cancer in pleomorphic adenoma,salivary duct carcinoma,mucoepidermoid carcinoma,myoepithelial carcinoma,acinar cell carcinoma and gland Cystic carcinoma,suggesting that the value of clinical CTC detection in the risk assessment of cancer in pleomorphic adenoma may be superior to other types of salivary gland malignancies.3.The high expression of Ki67,P63,CK7 and CK5 / 6 in salivary gland malignant tumor tissue is positively correlated with the detection of CTC,indicating that the detection of CTC is related to the malignant degree and invasiveness of the tumor,with high malignant degree and strong invasiveness The detection rate of CTC in peripheral blood of tumors is high,suggesting that CTC is one of the detection indicators of high-risk tumors of salivary glands.4.Carcinoma in pleomorphic adenoma,adenoid cystic carcinoma and mucoepidermoid carcinoma patients were positively correlated with the positive expression of CK7,Ki67,P63,and CK7,Ki67,P63 were the malignant degree and invasion of tumor Biomarkers of sexual and distant metastasis ability,so patients with CTC detection have a high risk of local recurrence and remote metastasis.It is recommended to perform adjuvant treatment and close follow-up after clinical surgery. |
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