The Correlation Of The Circulating Tumor Cells And Twist Expression With The Liver Metastasis Of Colorectal Cancer

Objective:To evaluate the expression levels of peripheral blood Twist and amplified circulating tumor cells(CTCs)in colorectal cancer(CRC)patients with liver metastasis,and to explore whether amplified CTCs and Twist can be used as a predictor of liver metastasis risk in CRC patients.Methods:Between September 2019 to November 2019,53 CRC patients and 5 healthy people were enrolled in this study,and were divided into liver metastasis group,non-Liver metastasis group and healthy control group.Cell enrichment was carried out by negative enrichment method of Cyttel~?technology,circulating tumor cells were identified by im-Fish identification technology and Twist expression was detected by immunofluorescence protein detection technology.All data in this study were analyzed by IBM SPSS 26.0.Student's t-test is used for measurement data,the enumeration data was used for chi-square test or Fisher exact test,Spearman Rank correlation analysis is used for correlation analysis,the test level is set to 0.05,ROC curve is used for diagnosis value comparison.Result:1.There were significant differences between the CRC patients and the healthy control group in the detection of amplified CTCs,Twist and Twist combined amplified CTCs(P<0.01).The sensitivity of Twist combined with amplified CTCs was higher than that of amplified CTC alone(94.3%vs84.9%).2.Relationship with liver metastasis of CRC:The number of Twist cells expressed in patients with liver metastasis of CRC was higher than that in patients with CRC without liver metastasis(2.13±2.19VS0.48±0.63,P=0.01).The diagnostic value of Twist(AUC=0.749,95%CI:0.606-0.887)was higher than that of amplified CTCs(AUC=0.394,95%C1:0.239-0.550)and combined detection method(AUC=0.555,95%CI:0.395-0.714),the cut-off value of Twist was 2 based on Youden's index;lymph node metastasis of colorectal cancer was correlated with the number of twist cells(0.20±0.42vs0.63±0.68,P=0.046).However,there was no statistically significant difference between the two groups in the amplified CTCs(3.25±2.47VS 3.97±2.15,P>0.05)and detection rate(79.2%VS 89.7%,P>0.05).3.Association with clinical features of CRC:the positive rate of amplified CTCs+twist in the left colon was higher than that in the right colon(100%vs85%,P=0.049).Amplified CTCs and Twist had no significant correlation with sex,age and tumor location.4.Relationship with pathological features of CRC:the number of amplified CTCs in poorly differentiated group was higher than that in moderately differentiated patients(6.25±1.71vs3.60±2.00,P?0.043).The number of amplified CTCs was positively correlated with the degree of CRC differentiation(correlation coefficient rs=0.451,P=0.14).The total number of amplified CTCs+twist cells in poorly differentiated patients was significantly higher than that in moderately differentiated patients(6.50±1.92vs4.12±2.13,P=0.38).Conclusion:The number of Twist cells expressed in peripheral blood is closely related to liver metastasis of CRC.Compared with amplified CTCs,it has higher diagnostic value in liver metastasis of colorectal cancer.Twist detection and combined amplified CTCs detection are expected to be the auxiliary diagnosis of colorectal cancer and the optimal monitoring index to predict the risk of liver metastasis.