Application of circulating tumor cell detection in decision making of neoadjuvant chemotherapy for gastric cancer / 肿瘤

ABSTRACT

Objective: To study the relationship between the number of circulating tumor cells (CTC) and the clinicopathological parameters of patients with gastric cancer, and its value in neoadjuvant chemotherapy for gastric cancer. Methods: The number of CTC in 83 patients with gastric cancer before the operation was detected by density gradient centrifugation combined with immunomagnetic negative enrichment and immunofluorescence in situ hybridization. The relationship between CTC number and the clinicopathological factors of patients with gastric cancer was analyzed by defining more than 3 CTCs in 5 mL peripheral blood as positive CTC. According to the random number table, 66 patients with advanced gastric cancer (24 cases in stage Ⅱ and 42 cases in stage III according the seventh edition of AJCC staging of cancer) were divided into neoadjuvant chemotherapy group and non-neoadjuvant chemotherapy group. The relationships of positive CTC, tumor pathological characteristic and neoadjuvant chemotherapy with the prognosis of gastric cancer patients were analyzed. Results: There was no statistical correlation of positive CTC in peripheral blood with gender, age, tumor location, carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), Borrmann typing, early and progressive stage, degree of differentiation, size of gastric cancer, depth of invasion, lymph node metastasis, distant metastasis and TNM stage (all P > 0.05) in gastric cancer patients. Neoadjuvant chemotherapy, tumor differentiation and positive CTC were independent prognostic factors for the patients with gastric cancer. Neoadjuvant chemotherapy prolonged the postoperative overall survival (OS) of patients with CTC-positive gastric cancer (P 0.05). Conclusion: CTC can appear in peripheral circulation blood of patients with early gastric cancer. The positive CTC is associated with poor prognosis of patients with gastric cancer. Neoadjuvant chemotherapy can prolong the OS of patients with CTC-positive gastric cancer, but has little value in the patients with CTC-negative advanced gastric cancer.