Detection Of Peripheral Blood Circulating Tumor Cells In Head And Neck Squamous Cell Carcinoma

Objectives To investigate the relationships between the circulating tumor cells(CTCs)counts and the clinicopathological characteristics of patients with head and neck squamous cell carcinoma(HNSCC),we detected CTCs in their peripheral blood and explored their prognostic value.Methods The clinicopathological data of 95 patients with HNSCC were collected in the oncology department of the ninth people's hospital affiliated to Shanghai JiaoTong University School of Medicine from January 2016 to January 2017,with and the CTCs count in peripheral blood were recorded one week before radiotherapy or chemotherapy.After that,we further analyzed the correlations of CTCs counts,clinicopathological characteristics,and the survivals of patients with HNSCC.The clinicopathological data of the patients with HNSCC were obtained according to the latest pathological results,including the primary tumor site,maximum tumor diameter,tumor invasion depth,lymph node infiltration,distant metastasis,pathological grade and clinical TNM stage.In order to accurately obtain the counts of CTCs in patients' peripheral blood,we identified CTCs in the samples by means of the technology of Cyttel Biosciences that combines negative enrichment and immunostaining-fluorescence in situ hybridization(im-FISH),and the samples of 20 healthy volunteers were also detected as control to verify its effectiveness.Results The Univariate analysis showed that CTCs-positive in patients with HNSCC was correlated with pathological grade(?2=9.851,p=0.002),lymph node N stage(?2=18.095,p<0.001),and clinical TNM stage(?2=21.220,p<0.001),rather than gender and age,tumor size(p>0.05).Nevertheless,multivariate analysis showed that the CTCs-positive was only significantly correlated with the N stage(p=0.003)and clinical TNM stage(p=0.002)of the patients with HNSCC.The Kaplan-Meier analysis indicated that CTCs positive was related to the progression free survival(PFS)and overall survival(OS)of patients with HNSCC,CTCs-positive patients had shorter PFS(HR: 1.894;95% CI:1.159-3.095;p= 0.006)and OS(HR: 2.529;95% CI:1.359-4.705;p= 0.002).But the COX multivariate regression analysis showed that CTCs-positive was not an independent prognostic factor(p>0.05).In addition,CTCs were not detected in the peripheral blood of 20 healthy volunteers,while the CTCs-positive rate was 63.2%(60/95)in 95 patients with HNSCC,with the statistically significant difference(?2=10.592,p=0.001).CONCLUSIONS The CTCs-positive in peripheral blood of patients with HNSCC were associated with N stage,clinical TNM stage and the poor outcomes,which could be used to guide the evaluation of clinical condition and might be used as a prognostic biomarker.