Clinical application of circulating tumor cells in the diagnosis of prostate cancer

Abstract

Objective To evaluate the diagnostic value of circulating tumor cells(CTCs) in prostate cancer (Pca) through studying the relationship between CTCs and Gleason scores and pathological TNM stage in Pca patients. Methods A total of 238 patients including 161 Pca patients as cancer group, 35 male patients with benign prostatic diseases as benign group and 42 male with non-prostate disease as control group, who were treated in our hospital from July 2016 to January 2018, were enrolled. Venous blood of every patient was collected and CTCs were enriched and identified by immunocytochemistry CD45 capturing leukocyte and fluorescence in situ hybridization with chromosome 8 (CEP8-FISH). Cells displaying CD45-/DAPI+/CEP8>2 were characterized as CTCs. One-way ANOVA was used to exam the correlations of the number of CTCs with Gleason scores and pathological TNM stage. Results CTCs ≥2 were detected in 74.53%(120/161) of Pca patients and 20.00% (7/35)of benign prostatic diseases patients and 7.14% (3/42)of control group (χ2=79.605,P<0.05). In group Gleason scores 6, the numbers of CTCs were 2.00±2.42, the ratios of CTCs≥5 and tetraploid were 13.33% (2/15)and 26.67%(4/15) respectively. In 7 scores group, the results were 3.14±2.68,17.72%(14/79) and 34.18%(27/79)respectively; In 8 scores group, the results were 3.57±2.70, 33.33%(7/21)and 42.86% (9/21)respectively; In 9 scores group, these three results were 4.65±4.41, 43.48%(20/46) and 45.65% (21/46)respectively. The numbers of CTCs in the ≤pT2b (20), pT2c(27), pT3a(19), pT3b(16)and ≥pT4(12) groups were 2.25±2.45, 3.56±2.79, 4.05±3.47, 4.69±2.12 and 5.17±3.21 respectively. The ratios of CTCs≥5 were 25.00%(5/20), 25.93%(7/27), 26.32%(5/19), 50.00%(8/16) and 58.33% (7/12)respectively. The proportions of tetraploid were 20.00%(4/20), 25.93% (7/27), 31.58%(6/19), 50.00%(8/16) and 58.33%(7/12) respectively. There were significant differences between CTC and Gleason scores (F=3.200,P<0.05)and pathological stage (F=2.673,P<0.05). The ratios of CTCs≥5 increased with the increase of Gleason scores (χ2=11.592, P<0.05). Conclusions The detection of CTCs could be used for the differential diagnosis of Pca and benign prostatic disease. There were notable correlations between the numbers of CTCs and Gleason scores and pathological stage in Pca patients, especially between CTCs≥5 and Gleason scores. Key words: Prostatic neoplasms; Neoplastic cells,circulating; Biomarkers,tumor; Neoplasm staging