Zhongliu Fangzhi Yanjiu (Sep 2020)
Early and Accurate Prediction of Postoperative Recurrence and Metastasis in Stage Ⅲ B Gastric Cancer Patients by Combination of CEA, PAK5 and Circulating Tumor Cells
Abstract
Objective To investigate the early and accurate prediction of recurrence and metastasis of stage ⅢB gastric cancer by CEA, PAK5 combined with CTC. Methods ELISA and multiple RNA/DNA in situ analysis were used to detect CEA, PAK5, CTC and imaging CT at the same time in 150 patients with stage ⅢB gastric cancer. Patients were divided into CEA progressive increase group (group A, n=50), CEA irregular increase group (group B, n=50) and control group (n=50). Results CEA: the median time of biological progress (T2) in the group A was 13(3-24) months, and that of the group B was 22(4-32) months; 39(78%) cases in group A had image progression and the median occurrence time of image progression (T3) was 6.2(5-8) months, and those were 12(24%) cases and 10.6(4-15) months in group B. The medium expression range of PAK5 at T2 was 13.6%-83% and the high expression range of PAK5 at T3 was 37.8%-100% in 51 patients with image progression. CTC test showed that the ratio of mixed type + interstitial type/total cell number > 30% could predict the biological progress time, and the ratio of mixed type + interstitial type/total single cell number > 50% and (or) interstitial-type cell number ≥1 could predict the imaging CT progression. In 39 patients with image progression in group A, the consistency of positive expression of CEA, PAK5 and CTC was 82% at biological progression time and 94% at image CT progression time. Conclusion Combined detection of CEA, PAK5 and CTC could early predict the recurrence and metastasis of stage Ⅲ B gastric cancer.
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