Objective  To explore the predictive effect of circulating tumor cells (CTCs) and CTC karyotypes in the peripheral blood on the prognosis of patients with non-muscle invasive bladder cancer (NMIBC).

  Methods  The clinical data of 109 patients who initially visited Affiliated Hospital of Chengde Medical College from May 2018 to May 2019 were selected, including 58 patients in the NMIBC group and 51 patients in the benign lesion group. The CTCs and the karyotypes were identified using differential enrichment and subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) techniques. Patients with ≥60% CTC triploidy were considered as triploid group and those with <60% as non-triploid group. The data of patients were analyzed for survival and prognosis.

  Results  The CTC positivity rate of the patients in the NMIBC group was 81.0% (47/58), which was significantly higher than that of the 9.8% (5/51) in the benign lesion group. Kaplan–Meier and Log-rank analyses showed that the disease-free survival (DFS) was significantly shorter in the pre- and postoperative triploid group than that in the non-triploid group (P<0.001) and in the postoperative patients with CTC than that in those without CTC (P<0.05). A multifactorial analysis of the Cox proportional risk regression model showed that preoperative and postoperative CTC karyotypes were the in dependent risk factors affecting the prognosis of patients with NMIBC.

  Conclusions  Pre- and postoperative monitoring of CTC and CTC karyotype are predictive of NMIBC, and CTC karyotype is an independent factor affecting prognosis.