Clinical significance of circulating tumor cells testing in auxiliary diagnosis ofgastrointestinal cancer

Abstract

Routine diagnostic tools and serum biomarkers of gastrointestinal (GI) cancer has limits in detecting early and micrometastasis,and circulating tumor cells (CTCs) had emerged as a promising metrics to complement this gap. The presentstudy is designed to explore technical feasibility of using CTCs as an auxiliary diagnostic tool in GI cancer. Over all 70inpatients with GI cancer and 30 healthy volunteers were recruited, and 10 mL of peripheral venous blood was collectedfrom all subjects. CTCs were detected by microfluidic blood rare cell analysis technique, and the sensitivity and specificityof CTCs in GI cancer diagnosis were derived from comparison with the pathological diagnosis results and tumor serummarker results. Compared with the healthy volunteers, the CTCs levels of the patients in gastrointestinal cancer group weresignificantly increased. Advanced stage subjects demonstrated higher level of CTCs, yet without statistical significance. Thesensitivity of CTCs to diagnose stage I to IV disease were 84.62%, 94.12%, 94.44%, and 100.00% respectively, yieldingcomprehensive sensitivity was 92.56% and specificity was 89.66%. Combined detection of CTCs and four tumor serummarkers was helpful in detecting positive rate, but without statistical signifiance compared with detecting CTCs alone. Ourstudy demonstrates the value of CTCs as an auxiliary diagnostic method for gastrointestinal cancer, and is expected to makeup for the deficiency of routine tissue biopsy, which can be used alone or in combination with conventional serum tumormarkers that can greatly promote the clinical diagnosis/prognosis of gastrointestinal cancer