Correlations of circulating tumor cells in peripheral blood with clinicopathological characteristics and effect of neoadjuvant chemotherapy on patients with gastric cancer
Objective To investigate the correlations between circulating tumor cells(CTCs)in peripheral blood and clinicopathological characteristics and the effect of neoadjuvant chemotherapy on patients with gastric cancer.Methods A total of 112 patients with gastric cancer admitted to the Third Affiliated Hospital of Xinxiang Medical University from March 2015 to February 2016 were selected as the research subjects.All patients were drawn 4 mL of fasting peripheral venous blood on the first day before treatment,and peripheral blood CTCs were detected by using negative enrichment combined with immunofluorescence.Based on the CTC detection results,the patients were divided into the CTC-positive group and the CTC-negative group.Patients in both groups were treated with neoadjuvant chemotherapy,including intravenous infusion of oxaliplatin 130 mg·m-2 on the first day and oral administration of capecitabine 1 000 mg·m-2,twice a day,on days 1-14;21 days was taken as one course of treatment,and a total of 3 courses of treatment was adopted.The clinicopathological characteristics of patients in the two groups were compared.The consistency of Response Evaluation Criteria in Solid Tumors(RECIST)and evaluation criteria of CTC count was analyzed by the Kappa test.The 3-year cumulative survival rate and 5-year cumulative survival rate of patients were calculated by the Kaplan-Meier survival analysis,and the 3-year cumulative survival rate and 5-year cumulative survival rate were compared by log-rank test between the CTC-positive group and the CTC-negative group.Results Among the 112 gastric cancer patients,64 patients(57.14％)tested positive for peripheral blood CTCs,and 48 patients(42.86％)tested negative for peripheral blood CTCs.After neoadjuvant chemotherapy,the number of patients with complete remission,partial remission,stable disease and progression of disease was 0,76,21 and 15 patients,respectively;and the effective rate of treatment was 67.86％(76/112).There were statistically significant differences in the depth of tumor invasion and TNM staging between the CTC-positive group and the CTC-negative group(P＜0.05);there was no statistically significant difference in gender,age,pathological type,size,location and differentiated degree of tumor,and vascular tumor embolus in the two groups(P＞0.05).The total effective rate in the CTC-positive group was 59.38％(38/64),and the total effective rate in the CTC-negative group was 79.17％(38/48);the total effective rate in the CTC-positive group was significantly lower than that in the CTC-negative group(x2=4.926,P＜0.05).RECIST and CTC count evaluation criteria were moderately consistent(Kappa=0.546).The 3-year cumulative survival rate and 5-year cumulative survival rate in the CTC-positive group were 75.6％and 26.7％,respectively;and the 3-year cumulative survival rate and 5-year cumulative survival rate in the CTC-negative group were 85.2％and 46.6％,respectively.There was no statistically significant difference in the 3-year cumulative survival rate of patients between the CTC-positive group and the CTC-negative group(P＞0.05).The 5-year cumulative survival rate of patients in the CTC-positive group was significantly lower than that in the CTC-negative group(P＜0.05).Conclusion The detection of CTCs helps assess the degree of tumor invasion and clinical staging of patients with gastric cancer and can evaluate the effect of neoadjuvant chemotherapy,showing certain predictive value for the long-term survival of gastric cancer patients.
维普
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