胃癌（GC）是癌症相关死亡的第四大原因，与晚期诊断和治疗耐药有关。目前，GC 筛查测试不具有成本效益或准确性较低。之前，我们描述了胃癌干细胞（GCSC；CD24 CD44 CD54 EpCAM）的扩展表型，该表型与胃癌患者的转移和肿瘤分期相关。当前研究的目标是评估GC患者和健康志愿者外周血中这些GCSC的存在情况。总共从 32 名 GC 患者和 41 名健康志愿者采集了 73 份血液样本。提取外周血单核细胞 (PBMC) 后，进行多参数流式细胞术寻找 GCSC。通过人工智能 (AI) 使用聚类数据，我们定义了循环 GCSC (cGCSC) 的高/低水平，并继续评估其与临床和预后变量的关联。最后，进行了诊断测试分析来评估患者和健康志愿者。我们发现大多数 GC 患者中都存在 cGCSC，平均浓度为 0.48%。 AI 聚类显示两组具有不同的 cGCSC 水平和临床特征。通过统计分析，我们证实了 cGCSC 水平与淋巴结转移、远处转移和总生存率之间的关联。诊断测试分析显示敏感性、特异性和曲线下面积 (AUC) 分别为 83%、95% 和 0.911。我们的结果表明，cGCSCs CD24 CD44 CD54 EpCAM 的评估可能是一种潜在的非侵入性测试，具有预后价值，并且对于 GC 筛查或诊断具有高度敏感性和特异性；然而，需要进行更大规模的研究来证实这一点。版权所有 © 2024 Jared Becerril-Rico 等人。

Gastric cancer (GC) is the fourth leading cause of cancer-related death, associated with late diagnosis and treatment resistance. Currently, screening tests for GC are not cost-effective or have low accuracy. Previously, we described an extended phenotype of gastric cancer stem cells (GCSCs; CD24+CD44+CD54+EpCAM+) that is associated with metastasis and tumor stage in GC patients. The goal of the current research is to evaluate the presence of these GCSCs in the peripheral blood of GC patients and healthy volunteers. A total of 73 blood samples were collected from 32 GC patients and 41 healthy volunteers. After peripheral blood mononuclear cell (PBMC) extraction, multiparametric flow cytometry was performed looking for GCSCs. Using clustering data through artificial intelligence (AI), we defined high/low levels of circulating GCSCs (cGCSCs) and proceeded to evaluate its association with clinical and prognostic variables. Finally, a diagnostic test analysis was performed evaluating patients and healthy volunteers. We found that cGCSCs are present in most GC patients with a mean concentration of 0.48%. The AI clustering showed two groups with different cGCSC levels and clinical characteristics. Through statistical analysis, we confirmed the association between cGCSC levels and lymph node metastasis, distant metastasis, and overall survival. The diagnostic test analysis showed sensibility, specificity, and area under the curve (AUC) of 83%, 95%, and 0.911, respectively. Our results suggest that the assessment of cGCSCs CD24+CD44+CD54+EpCAM+ could be a potential noninvasive test, with prognostic value, as well as highly sensitive and specific for screening or diagnosis of GC; however, a larger scale study will be necessary to confirm this.Copyright © 2024 Jared Becerril-Rico et al.