1.The relationship of circulating tumor cells in peripheral blood of pancreatic cancer patients with postoperative recurrence and prognosis
Senjuan LI ; Xiaoguang WANG ; Bin WU ; Chenxi CAO ; Lifeng QI ; Jianguo FEI ; Zhengxiang ZHONG
Chinese Journal of Pancreatology 2018;18(2):90-94
Objective To detect circulating tumor cells (CTCs) in the peripheral blood of patients with pancreatic cancer using a new nano microfluidic chip and to explore the relationship between CTCs and clinicopathological feature,postoperative recurrence and prognosis of pancreatic cancer.Methods The peripheral blood samples of 53 patients with pancreatic cancer who underwent curative resection in the second affiliated hospital of Jiaxing college of medicine were collected from January 2015 to January 2017.The CTCs from peripheral blood were detected by novel nano microfluidic chip.The cut-off value for CTCs-positive and negative groups was 1 CTC.The relationship between CTCs positive and postoperative recurrence and prognosis of pancreatic cancer were evaluated.Results The number of CTCs for 23 pancreatic cancer of 53 patients ranged from 5 to 196 per ml,and the mean number was 78.5 ± 44.7 per ml;the rate of CTCs-positive patients was 43.4% (23/53).There were significant correlation between CTCs with vascular invasion (P =0.001),but but CTCs was not correlated with the gender,age,the presence of clinical symptoms,tumor size,pathological type,lymph metastasis and TNM stage.31 patients had tumor recurrence,and the rate of tumor recurrence was 58.5%.Among them,there were 13 cases with tumor local recurrence,10 cases with tumor distant metastasis (including liver,lung,kidney,etc.) and 8 cases with both tumor local recurrence and distant metastasis.The median recurrence free survival time of all patients was 14.0 months (13.0-17.0) and the median overall survival time was 19.0 months (15.5-24.0).The cumulative one-year and two-year recurrence free survival rate were 66.9%,12.2% for patients with CTCs-positive and 88.3%,42.2% for CTCs-negative patients,and the differences were statistically significant (both P < 0.05).The cumulative one-year and two-year overall survival rate were 85.4%,33.6% for patients with CTCs-positive and 96.3%,62.2% for CTCs-negative.There was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate (P =0.028).Conclusions Peripheral blood CTCs of pancreatic cancer can be effectively detected by a novel nano microfluidic chip.There were significant correlation between CTCs with vascular invasion and survival time after surgery.CTCs may be a potential prognostic indicator of the postoperative recurrence and prognosis of pancreatic cancer.