Application Of EMT Typing Of Circulating Tumor Cells In Urinary System Tumors

Objective:To explore the application of circulating tumor cell typing based on epithelial mesenchymal transformation in urinary system tumors Methods:Retrospectively analyzed 63 patients with urinary system tumors in our hospital from peripheral venous blood circulating tumor cell detection,analysis of circulating tumor cells in patients with positive state,subtype,quantity and category of proportion and the general information of patients,such as laboratory testing index,tumor infiltration depth,whether there is any lymph node metastasis and the correlation of the existence of distant metastasis.SPSS Statistics 23.0 and Graph Pad Prism 7.0 were used for statistical analysis and plotting.A characteristic curve(ROC)was established to evaluate the value of T-CTCS count in the diagnosis of distant metastasis of urinary malignancies.The area under the curve(AUC)was used to assess the predictive power.In AUC>In the case of 0.5,the closer the AUC is to 1,the better the diagnostic effect is.Results:(1)In the analysis and comparison of the positive rate of CTCs in different tumor types and the distribution of CTCs in different subtypes,it was found that the positive rate of CTCs in prostate cancer was higher than that in urothelial carcinoma and renal carcinoma(96.4% vs 71.4%),and mixed CTCs accounted for more of them.(2)CTCS was closely related to lymph node metastasis: in the CTCS negative group,28 patients(53.8%)had lymph node metastasis,and 24 patients(46.2%)had no lymph node metastasis.In the CTCS positive group,there were 2 patients(18.2%)with lymph node metastasis,and 8 patients(81.8%)without lymph node metastasis.The results showed that the difference between the two groups was statistically significant(P=0.031).(3)CTCS was closely related to distant metastasis: there were 19 cases(36.5%)of distant metastasis in CTCS negative group,and 33 cases(63.5%)of no distant metastasis.In the CTCS positive group,there were 11 patients(100%)with distant metastasis,and 0 patients(0%)without distant metastasis.The results showed a statistically significant difference between the two groups(P=0.042).(4)The positive detection rates of epithelial CTCs,mesenchymal CTCs and mixed CTCs showed statistically significant differences in lymphatic metastasis and distant metastasis of tumors,with P values less than 0.05.T-CTC count,M-CTCs count and E/M-CTCs count in the comparison of T staging I+II and III+IV;T-CTC count and M-CTCs count in the comparison of lymph node metastasis;T-CTC count and M-CTCs count in the comparison of distant metastasis showed statistically significant differences,with P values less than 0.05;The ROC curve showed that T-CTCS counting combined with M-CTCS counting model for the diagnosis of distant metastasis had a sensitivity of 90% and a specificity of 48%,with 95%confidence interval of 0.572-0.835,P=0.011.Conclusion:Classification of CTCs using EMT markers helps identify more aggressive subtypes that are associated with tumor staging.