Dept. of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Oct 1;39(5):591-597. doi: 10.7518/hxkq.2021.05.015.
This study aims to investigate the diagnostic value of peripheral blood circulating tumor cells (CTCs) in oral squamous cell carcinoma (OSCC) and its correlation with the clinicopathological features of OSCC.
Ninety-three patients diagnosed as OSCC in the First Affiliated Hospital of Zhengzhou University from May 2019 to May 2020 were selected as the experimental group, and 20 healthy volunteers were employed as the control group. The CTCs value of peripheral blood of the patients were measured by CTCs detection technology, and its clinical significance was analyzed.
The CTCs values in the experimental group were higher than those in the control group, and the difference was statistically significant (<0.000 1). The CTCs value in the peripheral blood of patients in the experimental group were not correlated with gender, site of onset, and presence or absence of peripheral tissue infiltration (>0.05), but was correlated with age (=0.022), tumor T stage (=0.02), tumor N stage (=0.007 5), tumor M stage (=0.013), clinical stage (=0.029), early or late stage (=0.022), tumor differentiation degree (<0.001), and node metastasis (=0.006 4). The AUC value of CTCs in OSCC diagnosis was 0.925, and the energy efficiency was statistically significant [=0.000, 95%CI (0.876, 0.974)]. When the CTC value was 8.450 FU/3 mL, the maximum value of the Yoden index was 0.853, and the sensitivity and specificity of OSCC diagnosis were 90.3% and 95.0%, respectively. The AUC value of CTCs in the diagnosis of OSCC metastasis was 0.691, and the energy efficiency was statistically significant [=0.000, 95%CI (0.580, 0.803)]. When the blood CTC value was 12.250 FU/3 mL, the maximum value of Yoden index was 0.367, the sensitivity was 63.6%, and the specificity was 73.3%. Multivariate regression analysis showed that buccal tumor was negatively correlated with CTCs in patients with OSCC (=0.001 08), N2 stage (=0.000 74) and M stage (=0.026 38). High differentiation (<0.000 1) and moderate differentiation (=0.001 5) were negatively correlated with CTCs values in patients with OSCC.
Peripheral blood CTCs has important clinical value for early screening, auxiliary diagnosis, evaluation of metastasis, and determination of malignant degree, progression, and pathological grade of OSCC and a relatively reliable tumor detection indicator.
本研究旨在探讨外周血循环肿瘤细胞（CTC）在口腔鳞状细胞癌（OSCC）中的诊断价值及其与 OSCC 临床病理特征的关系。
选取 2019 年 5 月至 2020 年 5 月在郑州大学第一附属医院确诊为 OSCC 的 93 例患者为实验组，20 名健康志愿者为对照组。采用 CTCs 检测技术检测患者外周血中 CTCs 值，分析其临床意义。
实验组患者外周血 CTCs 值高于对照组，差异具有统计学意义（<0.000 1）。实验组患者外周血 CTCs 值与性别、发病部位、是否有外周组织浸润无关（>0.05），但与年龄（=0.022）、肿瘤 T 分期（=0.02）、肿瘤 N 分期（=0.007 5）、肿瘤 M 分期（=0.013）、临床分期（=0.029）、早期或晚期（=0.022）、肿瘤分化程度（<0.001）、淋巴结转移（=0.006 4）有关。CTC 对 OSCC 诊断的 AUC 值为 0.925，能量效率具有统计学意义[=0.000，95%CI（0.876，0.974）]。当 CTC 值为 8.450 FU/3 mL 时，Yoden 指数的最大值为 0.853，OSCC 诊断的灵敏度和特异性分别为 90.3%和 95.0%。CTC 对 OSCC 转移的诊断 AUC 值为 0.691，能量效率具有统计学意义[=0.000，95%CI（0.580，0.803）]。当血 CTC 值为 12.250 FU/3 mL 时，Yoden 指数的最大值为 0.367，灵敏度为 63.6%，特异性为 73.3%。多因素回归分析显示，颊部肿瘤与 OSCC 患者 CTC 呈负相关（=0.001 08），N2 期（=0.000 74）和 M 期（=0.026 38）。高分化（<0.000 1）和中分化（=0.001 5）与 OSCC 患者 CTC 值呈负相关。
外周血 CTCs 对 OSCC 的早期筛查、辅助诊断、转移评估以及恶性程度、进展和病理分级具有重要的临床价值，是一种较为可靠的肿瘤检测指标。
