Ning Dawei, Cui Kai, Liu Min, Ou Yang, Wang Zhendan, Zou Benkui, Shen Yangyang, Lu Xinyang, Li Sheng, Li Pang
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China (mainland).
Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China (mainland).
Med Sci Monit. 2021 Jan 7;27:e926565. doi: 10.12659/MSM.926565.
BACKGROUND The purpose of this study was to compare circulating tumor cells (CTCs)/circulating tumor microemboli (CTM) detection rates of the CellSearch and CTC-Biopsy systems in patients with gastric cancer (GC). We also investigated potential correlations between clinicopathological characteristics and prognosis in patients with GC. MATERIAL AND METHODS This prospective study was conducted at the Shandong Institute of Cancer Prevention and Control in China. Fifty-nine patients with GC and 22 healthy volunteers were recruited and their peripheral blood samples were examined by the CTC-Biopsy system and CellSearch system for CTC. RESULTS The rate of detection of CTCs/CTM was significantly higher with the CTC-Biopsy system than with the CellSearch system (59.32% vs. 27.12%, P<0.001). The Kappa value was 0.179, indicating poor consistency. CTCs detected with the CellSearch system in patients with stage III/IV GC was significantly correlated with neutrophil count (P=0.020), neutrophil/lymphocyte ratio (N/L ratio) (P=0.009), CA19-9 (P=0.049), tumor size (P=0.026), and the extent of vascular invasion (P=0.007). CTCs detected with the CTC-Biopsy system correlated with tumor differentiation (P=0.010). CTM in patients with stage I/II GC and stage II/IV GC correlated with CEA (P=0.004) and tumor differentiation (P=0.030), respectively. A CTC count >3 detected with the CellSearch system, and not the CTC-Biopsy system, correlated with reduced progression-free survival and overall survival. CONCLUSIONS The CTC-Biopsy system was superior to the CellSearch system for detecting CTCs in GC patients. CTM were detected with the CTC-Biopsy system but not with the CellSearch system. CTCs detected with the CellSearch system correlated with various clinicopathological factors and long-term survival outcomes.
背景 本研究旨在比较CellSearch系统和CTC活检系统对胃癌（GC）患者循环肿瘤细胞（CTC）/循环肿瘤微栓子（CTM）的检测率。我们还研究了GC患者临床病理特征与预后之间的潜在相关性。
材料与方法 本前瞻性研究在中国山东省肿瘤防治研究院进行。招募了59例GC患者和22名健康志愿者，并用CTC活检系统和CellSearch系统检测他们外周血样本中的CTC。
结果 CTC活检系统检测CTC/CTM的比率显著高于CellSearch系统（59.32%对27.12%，P<0.001）。Kappa值为0.179，表明一致性较差。CellSearch系统检测到的III/IV期GC患者的CTC与中性粒细胞计数（P=0.020）、中性粒细胞/淋巴细胞比率（N/L比率）（P=0.009）、CA19-9（P=0.049）、肿瘤大小（P=0.026）和血管侵犯程度（P=0.007）显著相关。CTC活检系统检测到的CTC与肿瘤分化相关（P=0.010）。I/II期GC患者和II/IV期GC患者的CTM分别与癌胚抗原（CEA）（P=0.004）和肿瘤分化相关（P=0.030）。CellSearch系统而非CTC活检系统检测到CTC计数>3与无进展生存期和总生存期降低相关。
结论 在检测GC患者的CTC方面，CTC活检系统优于CellSearch系统。CTC活检系统能检测到CTM，而CellSearch系统不能。CellSearch系统检测到的CTC与多种临床病理因素和长期生存结果相关。
