Background: Circulating tumor cells (CTCs) may be the missing renal cell carcinoma (RCC) biomarker. No-touch (NT) resection has shown benefit in several tumors. Methods: A randomized controlled trial comparing CTC and circulating mesenchymal cell (CMC) release in no-touch (NT) vs. conventional (C) laparoscopic RN. Blood samples were collected at operation room arrival (S0), specimen extraction (S1), postoperative D1, and D30. CTCs were isolated and analyzed using RUBYchip™. Results: Thirty-four patients were included. No significant differences were found between groups in CTC and CMC counts, count variations between time points, complications, and survival. The total circulating cell detection rates in the NT, C, and overall RCC groups were 58.3%, 80.0%, and 70.4% at S0; 41.6%, 86.7%, and 66.7% at S1; 50.0%, 64.3%, and 60.0% at D1; and 54.5%, 42.9%, and 44.0% at D30, respectively. A progressive decrease in CMCs was observed in the C group after surgery, especially at D1 (4.78 to 1.64 CMCs/7.5 mL blood,p= 0.035). Healthy controls had no circulating cells; however, high CMC counts were found in chronic inflammation controls and oncocytoma patients, with no significant difference from RCC patients (p= 0.460). Conclusions: NT RN did not reduce circulating cell release nor improve survival compared to C RN.
背景：循环肿瘤细胞（CTCs）可能是肾细胞癌（RCC）生物标志物研究中的缺失环节。无接触（NT）切除术已在多种肿瘤中显示出临床获益。方法：本研究开展了一项随机对照试验，比较无接触（NT）与传统（C）腹腔镜根治性肾切除术中CTC及循环间充质细胞（CMCs）的释放情况。分别在患者进入手术室时（S0）、标本取出时（S1）、术后第1天（D1）及第30天（D30）采集血液样本，使用RUBYchip™技术进行CTC分离与分析。结果：共纳入34例患者。两组在CTC与CMC计数、各时间点计数变化、并发症及生存率方面均无显著差异。NT组、C组及总体RCC组的循环细胞总检出率分别为：S0时点58.3%、80.0%、70.4%；S1时点41.6%、86.7%、66.7%；D1时点50.0%、64.3%、60.0%；D30时点54.5%、42.9%、44.0%。C组术后CMC呈渐进性下降，D1时点尤为显著（从4.78降至1.64 CMCs/7.5 mL血液，p=0.035）。健康对照组未检出循环细胞；而慢性炎症对照组与嗜酸细胞瘤患者均发现较高CMC计数，与RCC患者相比无显著差异（p=0.460）。结论：与传统根治性肾切除术相比，无接触根治性肾切除术既未减少循环细胞释放，也未改善患者生存率。
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