Clinical Value And Feasibility Of ISET In Detecting Circulating Tumor Cells In Early Breast Cancer

BackgroundBreast cancer is a systemic disease,and most early operable patients have better prognosis.However,once distant organ metastasis occurs,breast cancer will become very difficult to cure,which contributes to be the primary cause for death.A rare cell can be detected in the blood of some breast cancer patients.These cells detached from the primary tumor and entered the systemic blood circulation through blood vessels and lymphatics.Eventually,recurrence of the tumor occurred following surgical resection with adjuvant chemotherapy.These cells are called circulating tumor cells(CTC),CTCs are extremely rare,estimated at about 1 per billion of nucleated hematopoietic cells.Technically reliable circulating tumor cell detection methods allowed the collection of large datasets of CTC counts in cancer patients.These datasets can be used as a dynamic prognostic biomarker.Level-of-evidence-1 studies shows the clinical validity of detecting circulating tumor cells(≥1)as prognostic biomarkers for non-metastatic breast cancer,so the detection of CTC is particularly important.The detection process includes two steps: enrichment and labeling.Due to the rarity of circulating tumor cells,effective enrichment methods become the key to the whole detection process.At present,enrichment methods are usually divided into positive capture and negative enrichment.The sensitivity and specificity of these methods are various,and they all have some limitations.In order to fulfill the needs of medical care,we are trying to conduct a relatively more economical and convenient technique to isolate circulating tumor cells according to epithelial tumor cell size(ISET),namely microfiltration membrane enrichment.The purpose of this study was to demonstrate the clinical predictive value of detection of circulating tumor cells by microfiltration membrane enrichment in operable breast cancer,and the effect of circulating tumor cell count on molecular typing and pathological staging of breast cancer.MethodsThe experiment included 193 breast cancer patients who were diagnosed by pathology before operation.10 ml of venous blood was collected before operation,and the circulating tumor cells in their blood samples were counted and analyzed via ISET technique.ResultsThe total detection rate of circulating tumor cells by ISET was 41.24% in 193 patients with breast cancer undergoing operation.Subsequently,according to pathological type,histological grade,tumor(T)staging,lymph node metastasis,hormone receptor status,Her-2 status and Ki-67 status,analyze the detection rate,total circulating tumor cells and average circulating tumor cells in each group one by one.The final results showed that there was no statistically significant difference between each subgroups.In addition,1 case of male breast cancer and 1 case of histological grade I in 193 patients,in which circulating tumor cells were detected respectively.ConclusionISET has a relatively good detection rate for breast cancer patients,but ISET cannot provide more guidance from pathological staging,molecular typing and other aspects.Because of the insufficient sample size,the clinical significance of ISET for some subclasses can not be determined.