Preoperative circulating tumor cells as a prognostic indicator in gastric cancer

Table 1 Association between circulating tumor cells status and clinicopathological characteristics in patients with gastric cancer, n (%)

Characteristics	CTCs positive	CTCs negative	P value
Number of patients	61 (53.04)	54 (46.96)
Ages (years)			0.290
≥ 65	29 (47.54)	31 (57.41)
< 65	32 (52.46)	23 (42.59)
Gender			0.464
Male	39 (63.93)	38 (70.37)
Female	22 (36.07)	16 (29.63)
BMI, mean ± SD	22.28 ± 3.78	21.27 ± 3.49	0.140
Tumor size			0.495
≥ 4 cm	41 (67.21)	33 (61.11)
< 4 cm	20 (32.79)	21 (38.89)
Differentiation of tumor
High and medium	24 (39.34)	32 (59.26)	0.033
Low and none	37 (60.66)	22 (40.74)
Tumor location			0.301
Non-antrum	28 (45.90)	30 (55.56)
Antrum	33 (54.10)	24 (44.44)
pT			0.685
T1 + 2	16 (26.23)	16 (29.63)
T3 + 4	45 (73.77)	38 (70.37)
pN			0.038
No	12 (19.67)	20 (37.04)
Yes	49 (80.33)	34 (63.96)
pM			0.033
M0	51 (83.61)	52 (96.30)
M1	10 (16.39)	2 (3.70)
pTNM			0.040
I + II	18 (29.51)	26 (48.14)
III + IV	43 (70.49)	28 (51.85)
Perineural invasion			0.424
No	12 (19.67)	14 (25.93)
Yes	49 (80.32)	40 (70.07)
Lymphovascular invasion			0.420
No	13 (21.31)	15 (27.78)
Yes	48 (76.69)	39 (72.22)
Coagulation parameters, mean ± SD
PT	12.14 ± 1.01	12.56 ± 2.57	0.245
APTT	31.05 ± 7.21	34.47 ± 5.68	0.006
TT	14.75 ± 1.61	15.38 ± 1.34	0.027
FIB	3.67 ± 0.91	3.59 ± 0.68	0.642
D-dimer	443.56 ± 1190.99	112.16 ± 98.18	0.034
PLT	276.09 ± 83.54	232.25 ± 55.92	0.001

CTCs: Circulating tumor cells; BMI: Body mass index; PT: Prothrombin time; APTT: Activated partial thromboplastin time; TT: Thrombin time; FIB: Fibrinogen; PLT: Platelet; pTNM: Pathologic tumour, node, and metastasis.

Table 2 Univariate COX analysis of risk factors affecting progression-free survival in gastric cancer patients

Characteristics	β	SE	P value	OR	95%CI
Age	0.204	0.307	0.506	1.227	(0.672-2.240)
Gender	-0.502	0.320	0.871	0.949	(0.507-1.788)
BMI	-0.059	0.044	0.183	0.943	(0.865-1.028)
Tumor size	1.506	0.441	0.001	4.508	(1.898-10.705)
Differentiation of tumor	0.488	0.312	0.118	1.630	(0.884-3.005)
Tumor location	-0.015	0.305	0.961	0.985	(0.542-1.792)
pT	1.576	0.526	0.003	4.837	(1.725-13.564)
pN	1.560	0.526	0.003	4.759	(1.696-13.354)
pM	1.784	0.373	0.000	5.952	(2.863-12.372)
pTNM	1.393	0.414	0.001	4.027	(1.788-9.069)
Perineural invasion	2.796	1.013	0.006	16.375	(2.251-119.36)
Lymphovascular invasion	1.709	0.600	0.004	5.521	(1.704-17.888)
CTCs-positive	0.655	0.320	0.041	1.925	(1.027-3.605)

CTCs: Circulating tumor cells; BMI: Body mass index; pTNM: Pathologic tumour, node, and metastasis; OR: Odds ratio; CI: Confidence interval.

Table 3 Comparison of postoperative recurrence and metastasis between the two patient groups, n (%)

Location	CTCs positive (n = 28)	CTCs negative (n = 15)	P value
Locoregional	14 (50.00)	8 (53.33)	0.835
Peritoneal	18 (64.29)	7 (46.67)	0.264
Distant	22 (78.57)	10 (66.67)	0.394

CTCs: Circulating tumor cells.

Table 4 Recurrence and metastasis patterns in the circulating tumor cells-positive group

Patient-010	Liver
Patient-016	Liver, bone
Patient-019	Peritoneum, colon, pancreas, rectum, bladder
Patient-022	Peritoneum, liver
Patient-027	Regional node, liver, adrenal gland
Patient-028	Peritoneum, brain
Patient-036	Peritoneum, ureter, ovary
Patient-040	Liver
Patient-048	Anastomosis, peritoneum
Patient-050	Regionalnode, peritoneum, pelvis, greater omentum, liver, small intestine
Patient-051	Peritoneum, liver
Patient-052	Anastomosis, peritoneum
Patient-055	Gastric stump, peritoneum, liver, mesenteric lymph nodes
Patient-062	Peritoneum, retroperitoneal lymph nodes, small intestine
Patient-066	Peritoneum, ovary, lung
Patient-068	Regional node, liver
Patient-076	Peritoneum, small intestine
Patient-077	Anastomosis, small intestine
Patient-091	Regional node, peritoneum
Patient-093	Regional node, liver
Patient-096	Peritoneum, liver, colon, rectum, lung
Patient-097	Regional node
Patient-098	Regional node, peritoneum, pelvis, bladder
Patient-103	Regional node, peritoneum, greater omentum, mesentery, retroperitoneal lymph nodes, small intestine, ovary
Patient-108	Regional node
Patient-110	Peritoneum
Patient-112	Peritoneum, small intestine, greater omentum
Patient-115	Anastomosis, anterior pancreatic lymph nodes, ureter

Table 5 Recurrence and metastasis patterns in the circulating tumor cells-negative group

Patient-003	Peritoneum, bladder
Patient-009	Regional node
Patient-021	Anastomosis, ureter
Patient-023	Peritoneum, liver
Patient-038	Regional node, adrenal gland
Patient-045	Anastomosis, ureter, ovary
Patient-049	Anastomosis, gastric stump, peritoneum, liver, gallbladder, ovary, pancreas
Patient-053	Anastomosis
Patient-059	Anastomosis
Patient-060	Anastomosis, peritoneum
Patient-063	Bone
Patient-065	Peritoneum
Patient-072	Liver
Patient-085	Peritoneum, adrenal gland, bladder, uterus
Patient-109	Peritoneum