Relationship between circulating tumor cells level and clinicopathological features and prognosis in patients with advanced colorectal cancer

Abstract

Objective To investigate the relationship between circulating tumor cells (CTC) and clinicopathological characteristics and prognosis in patients with advanced colorectal cancer. Methods 180 cases of advanced colorectal cancer and 50 non tumor peripheral venous blood were collected from March 2016 to August 2017 in our hospital. The CTC cells of CK+ 4’, 6-diamidino-2-phenylindole (DAPI)+ CD45- were detected by flow cytometry. the relationship between CTC and the clinicopathological features and prognosis was analyzed by CTC. Results The circulating tumor cells were detected successfully in this study. 74 cases (41.11%) were positive for circulating tumor cells in 180 patients with advanced colorectal cancer, and 106 cases (58.89%) were negative. Circulating tumor cells was correlated with tumor differentiation, clinical stage, distal metastasis, serum carcinoembryonic antigen (CEA) level and lymph node metastasis (P=0.017, 0.023, 0.000, 0.000, 0.000). The median progression free survival (26 months) and total survival (57 months) in the circulating tumor cell positive group were significantly lower than those of the negative group (37 months) and the total survival period (92 months). The difference was statistically significant (Log-rank=3.193, P=0.014; Log-rank=5.109, P=0.007). The Cox proportional risk regression model found that tumor differentiation, clinical stage, distal metastasis, lymph node metastasis, and tumor circulating cells were correlated with total survival and progression free survival (P=0.015, 0.032, 0.018, 0.027, 0.009; P=0.009, 0.020, 0.011, 0.031, 0.006). Circulating tumor cells are independent risk factors affecting overall postoperative survival and progression free survival (P=0.009, 0.006). Conclusion Circulating tumor cells are closely related to the clinicopathological features and prognosis of patients with advanced colorectal cancer. Key words: Advanced colorectal cancer; Circulating tumor cells; Clinicopathological features; Prognosis