Circulating tumor cells with chromosome 8 aneuploidy are a diagnostic and prognostic monitoring biomarker for ovarian cancer
摘要Objective:We investigated the clinical value of a novel circulating tumor cell(CTC)detection method-subtraction enrichment combined with immunostaining and fluorescence in situ hybridization(SE-iFISH)-in ovarian cancer(OC).This study evaluated the diagnostic and prognostic significance of chromosome 8 aneuploidy in CTCs and circulating tumor endothelial cells(CTECs)for preoperative diagnosis,treatment efficacy assessment,and recurrence monitoring.Methods:A total of 331 patients were enrolled,including 56 with newly diagnosed primary OC,265 with benign ovarian tumors,and 10 with borderline tumors.Peripheral blood CTCs and CTECs were detected using SE-iFISH;their quantity and ploidy characteristics were analyzed in relation to clinical indicators.To assess dynamic CTC changes during disease progression and treatment response,72 patients were followed longitudinally,of whom 19 experienced recurrence.Results:The CTC detection rate in OC patients was 92.9%,with significantly higher counts than that in the benign tumor group(median 5 vs.2).Receiver operating characteristic analysis demonstrated good diagnostic performance for total CTCs[area under the curve(AUC)=0.699],with triploid CTCs achieving the highest efficacy(AUC=0.792),surpassing carbohydrate antigen 125(CA125)(AUC=0.702).Postoperative follow-up showed that 70%of patients exhibited concurrent decreases in CTCs and CA125 levels,indicating disease improvement.In 30%of patients,CTC levels did not correlate with changes in CA125 levels.Individual case evidence suggests that CTC alterations may serve as an early indicator of recurrence or metastasis.Among the 19 recurrent cases,73.7%showed elevated CTCs at recurrence that decreased following treatment.In four patients,CTCs reflected disease progression earlier than CA125,indicating higher sensitivity for recurrence monitoring.Conclusions:CTCs with chromosome 8 aneuploidy demonstrate significant clinical value in the preoperative diagnosis,treatment efficacy evaluation,and recurrence monitoring of OC.Dynamic CTC changes may serve as a more sensitive indicator than CA125 for disease surveillance,supporting the translational potential of CTC-based biomarkers in OC.
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