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| Predictive value of CTCs combined with PLR for recurrence and metastasis of cervical cancer patients |
| Qiu Ping, Chen Guoying, Shi Shulan |
| Department of Gynecology Jingjiang People??s Hospital Jingjiang 214500 Jiangsu China |
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Abstract Objective This study aims to investigate the correlations between circulating tumor cells CTCs count and clinicopathologic
characteristics and the prognosis of cervical cancer patients and to further explore the predictive value of CTCs combined with platelet
to lymphocyte ratio PLR for the recurrence and metastasis in cervical cancer patients. Method This analysis included 113 FIGO
stage ⅠB-ⅡA patients who underwent surgical resection for cervical cancer in our hospital from September 2016 to September 2018.
The CTCs of each patient were identified and counted and their correlations with the clinicopathological characteristics of cervical
cancer patients was analyzed. All patients were reclassified into different research groups based on the CTCs PLR and their
combination. The 3-year disease-free survival DFS of cervical cancer patients in different groups was calculated by the KaplanMeier curves and the log-rank test was used to compare the survival differences between various groups. Result On the basis of the
definition of positive CTCs all cervical cancer patients were divided into CTCs ≤1 and CTCs >1 groups. The analytic results indicated
that CTCs >1 were significantly associated with cervical adenocarcinoma χ2 = 8. 054 P= 0. 018 myometrium invasion ≥1 / 2
χ
2 =
5. 512 P= 0. 019 FIGO IIA stage
χ
2 = 4. 484 P= 0. 034 high neutrophil-to-lymphocyte ratio ≥2. 20
χ
2 = 4. 341 P= 0. 037
and PLR ≥130. 4
χ
2 = 4. 240 P= 0. 039 . The 3-year DFS of patients with CTCs ≤1 and CTCs > 1 were 79. 6% and 40. 4%
respectively
χ
2 = 18. 938 P<0. 001 . CTCs >1 suggested a poorer prognosis for cervical cancer patients. The 3-year DFS of patients
with PLR <130. 4 and PLR ≥130. 4 were 81. 6% and 48. 6% respectively
χ
2 = 18. 938 P<0. 001 . In addition Kaplan-Meier
curves showed that CTCs combined with PLR further improved the prognostic stratification for cervical cancer patients with FIGO
IB-IIA stage. The 3-year DFS of patients with CTCs ≤1 and PLR <130. 4 CTCs >1 or PLR ≥130. 4 as well as CTCs >1 and PLR
≥130. 4 were 89. 4% 64. 1% and 16. 8% respectively. There were significant survival differences between the research groups
89. 4% vs 16. 8%
χ
2 = 33. 083 P<0. 001 89. 4% vs 64. 1%
χ
2 = 5. 779 P= 0. 016 64. 1% vs 16. 8%
χ
2 = 12. 154 P<0. 001 .
·474· 肿瘤代谢与营养电子杂志 2022 年 8 月 9 日第 9 卷第 4 期 Electron J Metab Nutr Cancer, Aug. 9, 2022, Vol. 9, No. 4
The univariate and multivariate Cox survival analysis revealed that CTCs combined with PLR HR= 5. 732 95%CI = 1. 966—16. 713
P<0. 001 and FIGO stage HR = 2. 688 95%CI = 1. 272—5. 680 P = 0. 010 were independent predictors of poor DFS for cervical
cancer patients. Conclusion CTCs count in the peripheral blood is a valuable prognostic marker for cervical cancer patients and CTCs
combined with PLR might be helpful to further identify patients at high risk and provide key clinical guidance for recurrence monitoring
and individualized management.
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Received: 15 March 2022
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