Clinical value of detection of circulating tumor cell and circulating tumor stem cell in colorectal cancer screening in Lynch syndrome family

Abstract

Objective To study the clinical value of detection of circulating tumor cell (CTC) and circulating tumor stem cell (CTSC) in the colorectal cancer (CRC) screening in Lynch syndrome family. Methods A total of 76 patients with CRC from Lynch syndrome family in the Second Affiliated Hospital of Zhengzhou University from December 2012 to December 2018 were selected for the study. The clinical information were collected form all patients after admission, and the related examinations were performed. And then the patients were given selective surgery, and the 15 ml fasting peripheral venous blood was collected before and after operation to detect the CTC and CTSC. And the relationship between detection resultsandpositive ratesof peripheral blood CTC and CTSCand patientstaging and prognosis was analyzed. Results In peripheral blood of 76 patients with CRC from Lynch syndrome family, the number of CTCs was 4.6 (0-117)/7.5 ml before operation and 4.9 (0-124)/7.5 ml after operation, and the number of CTSC1 was 0.7 (0-28)/7.5 ml before operation and 0.6 (0-29)/7.5 ml after operation, and the number of CTSC2 was 0.1 (0-14)/7.5 ml before operation and 0.1 (0-16)/7.5ml after operation, and the number of CTSC3 was 0 before operation and after operation. The positive rates of CTC, CTSC1 and CTSC2 before and after operation were 40.79% and 46.05% (P>0.05), 43.42% and 42.11% (P>0.05), 3.95% and 5.26% (P>0.05). There were statistically significant differences in the CTC positive rates before and after operation in peripheral blood of patients with CRC from Lynch syndrome family in different TNM stages, N stages and M stages (P<0.05). There were statistically significant differences in the CTSC1 positive rates before and after operation in peripheral blood of patients with CRC from Lynch syndrome family in different M stages (P<0.05). The positive rates of CTC and CTSC before and after operation in patients with recurrence were significantly higher than those in patients without recurrence (P<0.05). Conclusions The detection of CTC and CTSC in patients with CRC from Lynch syndrome family is helpful to determine the biological behavior of tumors and improve the accuracy of clinical staging, so as to provide a reference for the evaluation of tumor metastasis and postoperative recurrence, and it has guiding significance on CRC diagnosis, treatment, disease monitoring and prognosis evaluation. Key words: Lynch syndrome family; Colorectal cancer screening; Circulating tumor cell; Circulating cancer stem cell