The expression and prognostic value of serum circulating tumor cells in gastric cancer patients

Yuan Jianlei; Wang Zhao; Hu Tao; Zhang Yunhao; Wang Guangyu

doi:10.3969/j.issn.1671-6450.2025.07.009

Abstract：Objective Exploring the value of serum circulating tumor cells(CTCs)in prognostic evaluation of gastric cancer surgery patients.Methods A retrospective study was conducted on 86 patients with gastric cancer admitted from January 2019 to January 2021.The expression of CTCs was detected and divided into a CTCs positive group of 78 cases and a CTCs negative group of 8 cases.The relationship between different CTCs expression and CTCs positive patients of dif-ferent subtypes and clinical staging,efficacy,and prognosis of gastric cancer was analyzed.Results The positive rate of gas-tric cancer patients was 90.70％,and the level of CTCs was(5.12±0.14)/5ml,there were significant difference(F/P=11.932/0.001).Subtype analysis showed that there were 18 cases of stromal type,with an average detection of(1.51±0.06)/5ml,epi-thelial type(1.82±0.11)/5ml,and mixed type(3.52±0.21)/5ml.The detection rates of CTCs in T3-4 stage,N1-3 stage,and AJCC stage Ⅲ patients were higher than those in T1-2 stage,N0 stage,and AJCC stage Ⅰ-Ⅱ,respectively,and the differ-ences were statistically significant(x2/P=6.710/0.010,8.006/0.005,6.323/0.012),and the positive rates of CTCs in different subtypes were also statistically significant(x2/P=4.256/0.044,34.864/＜0.001,22.508/＜0.001).The detection rate of postopera-tive CTCs was significantly lower than that before surgery,and the difference was statistically significant(90.70％vs.13.96％,x2/P=101.522/＜0.001).The detection rate of CTCs in different CTCs subtypes also showed statistically significant differences(x2/P=7.205/0.027).The survival rate of CTCs positive patients was significantly lower than that of CTCs negative patients,and the PFS and OS were significantly lower than those of CTCs negative group,with statistical significance(P＜0.001).The 3-year survival rate of CTCs interstitial type patients was significantly lower than that of CTCs epithelial type and CTCs mixed type patients,and the PFS and OS were significantly lower than those of CTCs epithelial type and CTCs mixed type patients,with statistical significance(P＜0.001).Conclusion Gastric cancer patients have a very high positive detection rate of CTCs,and there are multiple subtypes.The positive rate and subtypes of CTCs are closely related to the clinical stage and prognosis of patients.