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Ghose A, McCann L, Makker S, Mukherjee U, Gullapalli SVN, Erekkath J, Shih S, Mahajan I, Sanchez E, Uccello M, Moschetta M, Adeleke S, Boussios S. Diagnostic biomarkers in ovarian cancer: advances beyond CA125 and HE4. Ther Adv Med Oncol 2024; 16:17588359241233225. [PMID: 38435431 PMCID: PMC10908239 DOI: 10.1177/17588359241233225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Ovarian cancer (OC) is the most lethal gynaecologic malignancy, attributed to its insidious growth, non-specific symptoms and late presentation. Unfortunately, current screening modalities are inadequate at detecting OC and many lack the appropriate specificity and sensitivity that is desired from a screening test. Nearly 70% of cases are diagnosed at stage III or IV with poor 5-year overall survival. Therefore, the development of a sensitive and specific biomarker for early diagnosis and screening for OC is of utmost importance. Currently, diagnosis is guided by CA125, the patient's menopausal status and imaging features on ultrasound scan. However, emerging evidence suggests that a combination of CA125 and HE4 (another serum biomarker) and patient characteristics in a multivariate index assay may provide a higher specificity and sensitivity than either CA125 and HE4 alone in the early detection of OC. Other attempts at combining various serum biomarkers into one multivariate index assay such as OVA1, ROMA and Overa have all shown promise. However, significant barriers exist before these biomarkers can be implemented in clinical practice. This article aims to provide an up-to-date review of potential biomarkers for screening and early diagnosis of OC which may have the potential to transform its diagnostic landscape.
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Affiliation(s)
- Aruni Ghose
- Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Department of General Medicine, Newham University Hospital, Barts Health NHS Trust, London, UK
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham, UK
- Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK
| | - Lucy McCann
- Department of General Medicine, Newham University Hospital, Barts Health NHS Trust, London, UK
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Shania Makker
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- University College London Cancer Institute, London, UK
| | - Uma Mukherjee
- Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- University College London Cancer Institute, London, UK
| | | | - Jayaraj Erekkath
- Department of Medical Oncology, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, UK
| | - Stephanie Shih
- Department of General Medicine, Newham University Hospital, Barts Health NHS Trust, London, UK
| | - Ishika Mahajan
- Department of Acute Medicine, Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, Lincolnshire, UK
- Department of Medical Oncology, Apollo Cancer Centre, Chennai, Tamil Nadu, India
| | - Elisabet Sanchez
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham, UK
| | - Mario Uccello
- Department of Medical Oncology, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Sola Adeleke
- Department of Clinical Oncology, Cancer Centre at Guy’s, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, King’s College London, Guy’s Campus, London, WC2R 2LS, UK
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham, UK
- Faculty of Life Sciences and Medicine, School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
- Kent and Medway Medical School, University of Kent, Canterbury, UK
- AELIA Organization, Thermi, Thessaloniki, Greece
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Tang Q, Zhang H, Tang R. Identification of two immune subtypes and four hub immune-related genes in ovarian cancer through multiple analysis. Medicine (Baltimore) 2023; 102:e35246. [PMID: 37800814 PMCID: PMC10553066 DOI: 10.1097/md.0000000000035246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/24/2023] [Indexed: 10/07/2023] Open
Abstract
Immune classification of ovarian cancer (OV) becomes more and more influential for its immunotherapy. However, current studies had few immune subtypes of OV. It is urgent to explore the immune subtypes and deeper hub immune-related genes (IRGs) of OV for follow-up treatment. A total number of 379 OV samples were obtained from UCSC online website. Single sample gene set enrichment analysis of 29 immune gene sets was used for identifying immune subtypes of OV and gene set variation analysis were used for exploring the hallmarks and Kyoto Encyclopedia of Genes and Genomes pathways of immune types. Two immunity subtypes (Immunity_H and Immunity_L) were identified by single sample gene set enrichment analysis. The OV patients in Immunity_H group had longer overall survival compared with those in Immunity_L group. The Immunity_H had higher stromal score, immune score and estimate score and the tumor purity had the adverse tendency. Besides, the gene set variation analysis enrichment results showed positive relationship between improved immunoreaction and pathways correlated to classical signaling pathway (PI3K/AKT/MTOR, P53, TNFA/NFkB signaling pathways) and immune responses (T/B cell receptor signaling pathways and primary immunodeficiency). Furthermore, 4 hub IRGs (CCR5, IL10RA, ITGAL and PTPRC) were jointly dug by weighted gene co-expression network construction and Cytoscape. Our team also explored the mutations of 4 hub IRGs and PTPRC showed nearly 7% amplification. Besides, 8 immune-checkpoint genes had higher expression in Immuity_H group compared with Immuity_L group, except CD276. The correlation between PD-1/PD-L1 and 4 hub IRGs were explored and gene set enrichment analysis were conducted to explore the underlying mechanisms of PTPRC in OV. Finally, western-blotting showed PTPRC could regulate immune checkpoint PD-L1 expression via JAK-STAT signaling pathway. In a word, 2 immune subtypes and 4 hub IRGs of OV were identified by multiple analysis.
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Affiliation(s)
- Qin Tang
- Department of Obstetrics and Gynecology, The Jingmen Center Hospital, Jingmen, PR China
| | - Haojie Zhang
- Department of Operating Room, The Jingmen Center Hospital, Jingmen, PR China
| | - Rong Tang
- Department of Pathology, The Jingmen Center Hospital, Jingmen, PR China
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Ring A, Nguyen-Sträuli BD, Wicki A, Aceto N. Biology, vulnerabilities and clinical applications of circulating tumour cells. Nat Rev Cancer 2023; 23:95-111. [PMID: 36494603 PMCID: PMC9734934 DOI: 10.1038/s41568-022-00536-4] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
In recent years, exceptional technological advances have enabled the identification and interrogation of rare circulating tumour cells (CTCs) from blood samples of patients, leading to new fields of research and fostering the promise for paradigm-changing, liquid biopsy-based clinical applications. Analysis of CTCs has revealed distinct biological phenotypes, including the presence of CTC clusters and the interaction between CTCs and immune or stromal cells, impacting metastasis formation and providing new insights into cancer vulnerabilities. Here we review the progress made in understanding biological features of CTCs and provide insight into exploiting these developments to design future clinical tools for improving the diagnosis and treatment of cancer.
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Affiliation(s)
- Alexander Ring
- Department of Biology, Institute for Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
- Department of Medical Oncology and Hematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bich Doan Nguyen-Sträuli
- Department of Biology, Institute for Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
- Department of Gynecology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andreas Wicki
- Department of Medical Oncology and Hematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Nicola Aceto
- Department of Biology, Institute for Molecular Health Sciences, ETH Zurich, Zurich, Switzerland.
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Gao T, Mao J, Huang J, Luo F, Lin L, Lian Y, Bin S, Zhao L, Li S. Prognostic significance of circulating tumor cell measurement in the peripheral blood of patients with nasopharyngeal carcinoma. Clinics (Sao Paulo) 2023; 78:100179. [PMID: 36963168 PMCID: PMC10064788 DOI: 10.1016/j.clinsp.2023.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/12/2022] [Accepted: 01/04/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVE Nasopharyngeal Carcinoma (NPC) is lethal cancer. Typically, relapse and metastasis are the outcomes of most patients. Against this backdrop, this study aimed to investigate the correlation between Circulating Tumor Cell (CTC) profiles and clinicopathological features in patients with NPC. PATIENTS AND METHODS A total of 119 blood samples from 79 patients were collected from patients with NPC during treatment. CanPatrolTM CTC enrichment and RNA In Situ Hybridization (RNA-ISH) were used to characterize CTCs, including epithelial, Mesenchymal (MCTCs), and epithelial/mesenchymal mixed types according to their surface markers. RESULTS The number of CTCs and MCTCs in the pre-treatment group was significantly higher than that in the post-treatment group (p < 0.05). The total number of CTCs and MCTCs cell numbers was significant correlation with Tumor-Node-Metastasis (TNM) staging (p < 0.05), Progression-Free Survival (PFS), and Overall Survival (OS). The PFS of patients with > 7 CTCs or > 5 MCTCs per 5 mL blood was significantly shorter PFS than those patients with ≤ 7 CTCs or ≤ 5 MCTCs (p < 0.05). Patients treated with targeted therapy combined with chemoradiotherapy had poorer PFS and OS rates than those treated with chemoradiotherapy (p < 0.05). The Kaplan-Meier survival analysis also demonstrated that patients with changes in CTC > 4 were strongly associated with PFS and OS rates (p < 0.05). CONCLUSION CTC and MCTC number detection in patients with NPC is a useful biomarker for predicting patient progress. Patients with more than 7 CTCs or 5 MCTCs in 5 mL of blood had shorter PFS and OS rates. CTC and MCTC count changes were also significantly associated with the patient's therapy.
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Affiliation(s)
- Tinghua Gao
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Jinxing Mao
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Jindu Huang
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Fengling Luo
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Lixiang Lin
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Yingni Lian
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Sanmei Bin
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Lianghua Zhao
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China
| | - Shuping Li
- Department of Oncology, First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong, China.
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Cai M, He H, Hong S, Weng J. Synergistic diagnostic value of circulating tumor cells and tumor markers CEA/CA19-9 in colorectal cancer. Scand J Gastroenterol 2023; 58:54-60. [PMID: 35968572 DOI: 10.1080/00365521.2022.2106152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Circulation tumor cells (CTCs) play a crucial role in cancer spread and have a strong correlation with cancer progression. Previous works of research have shown that the number of CTCs can be used to predict the recurrence of colorectal cancer (CRC). METHODS In this study, we used the Cyttel method to isolate and detect CTCs, and analyzed their correlation with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels. RESULTS We found that the amount and positive (CTC number ≥2 in 3.2 mL peripheral blood) rate of CTCs were higher in peripheral blood (PB) of patients in stage III/IV than that of patients in stage I/II, suggesting the number of CTCs in CRC patients may have a higher correlation with metastasis. Furthermore, the number of CTCs was correlated to CEA and CA19-9 levels in individuals with all stages of CRC, and all of them predicted a worse prognosis and higher recurrence rate. Notably, triple positive (CTCs ≥ 2, CEA ≥ 5 ng/mL, CA19-9 ≥ 37 U/mL in PB) leads to the worst outcome indicated by overall survival and recurrence rate. CONCLUSION Taken together, this study first revealed that a triple combination of CTCs, which were detected by the Cyttel method but not other approaches, CEA and CA19-9 is a promising prognostic marker on the recurrence of colorectal cancer and overall survival in clinic practice.
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Affiliation(s)
- Mingzhi Cai
- Department of General Surgery, ZhangZhou Affiliated Hospital of FuJian Medical University, Fujian, China
| | - Huiduan He
- Department of Pathology, ZhangZhou Affiliated Hospital of FuJian Medical University, Fujian, China
| | - Shaojun Hong
- Department of Pathology, ZhangZhou Affiliated Hospital of FuJian Medical University, Fujian, China
| | - Jianming Weng
- Department of Pathology, ZhangZhou Affiliated Hospital of FuJian Medical University, Fujian, China
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Chen J, Wang H, Zhou L, Liu Z, Tan X. A combination of circulating tumor cells and CA199 improves the diagnosis of pancreatic cancer. J Clin Lab Anal 2022; 36:e24341. [PMID: 35334495 PMCID: PMC9102772 DOI: 10.1002/jcla.24341] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/29/2022] [Accepted: 02/27/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is difficult due to the lack of effective screening tests. CA199, the standard biomarker for PDAC management, is not sufficiently reliable for early diagnosis. This prospective study aimed to evaluate whether circulating tumor cells (CTCs) could complement or perform better than CA199 in determining PDAC. METHODS A total of 168 blood samples were collected from 80 patients with PDAC, 32 patients with acute pancreatitis, 22 patients with benign pancreatic masses, and 34 healthy donors. CTCs were detected by a novel system combining negative enrichment with immunostaining and fluorescence in situ hybridization (NE-imFISH). Next, ROC curves and AUC analyses were conducted to assess diagnostic abilities of CA199, CTCs, and the combination of the two biomarkers in PDAC. RESULTS CTCs were stained as CD45-/DAPI+/CEP8 ≥3. With 2 CTCs/3.2 ml as the cut-off value, the sensitivity/specificity of the CTC number was 0.76/0.94, which was comparable to that of CA199 (0.78/0.83; Delong test p = 0.3360). Improved performance was achieved through a logistic regression model integrating CA199 and CTC number (AUCCTC+CA199 = 0.95, AUCCA199 = 0.80, AUCCTC number = 0.85; Delong test p vs . CA199 < 0.0001 and p vs . CTC number = 0.0002). CTC subtype was inferior to CTC number as a diagnostic marker (AUCCTC subtype = 0.73; Delong test p vs . CTC number < 0.0001). CONCLUSION The dual-marker panel consisting of CA199 and CTC number can significantly improve upon the diagnostic performance of CA199 alone, highlighting the promising clinical utilization as an effective strategy for PDAC surveillance.
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Affiliation(s)
- Junliang Chen
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Huaitao Wang
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Lei Zhou
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Zhihao Liu
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Xiaodong Tan
- Department of General SurgeryShengjing Hospital of China Medical UniversityShenyangChina
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Jou HJ, Ling PY, Hsu HT. Circulating tumor cells as a "real-time liquid biopsy": Recent advances and the application in ovarian cancer. Taiwan J Obstet Gynecol 2022; 61:34-39. [PMID: 35181043 DOI: 10.1016/j.tjog.2021.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 10/19/2022] Open
Abstract
Even with the latest advances in technology, the treatment of ovarian cancer remains a big challenge because it is typically diagnosed at advanced stage, is prone to early relapse in spite of aggressive treatment and has an extremely poor prognosis. Circulating tumor cells (CTCs) can be used as a non-invasive "real-time liquid biopsy", which has shown the value of diagnosis, assessment of prognosis and chemoresistance, and detection of small residual tumors on ovarian cancer. This review article provides an overview on recent research on CTCs in ovarian cancer, with special focus on the clinical application of CTC tests.
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Affiliation(s)
- Hei-Jen Jou
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; International College of Semiconductor Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan.
| | - Pei-Ying Ling
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Heng-Tung Hsu
- International College of Semiconductor Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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Chen K, Chen Z, Ou M, Wang J, Huang X, Wu Y, Zhong W, Yang J, Huang J, Huang M, Pan D. Clinical significance of circulating tumor cells in predicating the outcomes of patients with colorectal cancer. Clinics (Sao Paulo) 2022; 77:100070. [PMID: 36087570 PMCID: PMC9464896 DOI: 10.1016/j.clinsp.2022.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Relapse and metastasis of patients with Colorectal Cancer (CRC) is the major obstacle to the long-term life of patients. Its mechanisms remain defined. METHODS A total of 48 CRC patients were enrolled and 68 samples were obtained from the peripheral blood of patients before or after treatments in this study. Twenty non-cancer patients were also detected as a negative control. Circulating Tumor Cells (CTCs), including Epithelial CTCs (eCTCs), Mesenchymal (MCTCs), and epithelial/mesenchymal mixed phenotypes (mixed CTCs), were identified by CanPatrolTM CTC enrichment and RNA in situ hybridization. The relationship between CTCs number and Progression-Free Survival (PFS) or Overall Survival (OS) was evaluated. RESULTS Thirty-four of 48 patients (70.8%) were found to have positive CTCs. Total CTCs and MCTCs in the post-treatment had a significant correlation PFS and OS. When total CTCs or MCTCs in 5 mL blood of patients were more than 6 CTCs or 5 MCTCs, PFS of the patients was significantly shorter (p < 0.05) than that in patients with less than 6 CTCs or 5 MCTCs. The patients with > 5 CTCs count changes were found to exhibit poor PFS and OS rates (p < 0.05). CONCLUSION Total CTCs and MCTCs number detection in patients with colorectal cancer was very useful biomarker for predicting the prognosis of patients. Higher CTCs or MCTCs had poorer PFS and OS rates.
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Affiliation(s)
- Kehe Chen
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhenxiang Chen
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Mei Ou
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Junping Wang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yingying Wu
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Wenhe Zhong
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiao Yang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinging Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Min Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Deng Pan
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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Yang J, Cheng S, Zhang N, Jin Y, Wang Y. Liquid biopsy for ovarian cancer using circulating tumor cells: Recent advances on the path to precision medicine. Biochim Biophys Acta Rev Cancer 2021; 1877:188660. [PMID: 34800546 DOI: 10.1016/j.bbcan.2021.188660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 12/30/2022]
Abstract
Ovarian cancer (OC) is the most lethal gynecologic malignance worldwide. Considering its metastasis nature, oncologists shift focus towards circulating tumor cells (CTCs), a progenitor that originates from primary tumor and undergoes morphologic/genetic alterations to enter bloodstream and invade nearby tissues. Mountains of evidence suggested that CTCs could provide deep insights into genomic, transcriptomic, and proteomic profiling of OC metastatic cascades. To pave the way for precision medicine, researchers exert great efforts to develop isolation/detection methodologies and construct CTCs-derived propagation platforms, including traditional cell cultures, patient-derived xenografts (PDXs), and organoids. From bench to bedside, CTCs provide minimally-invasive means to inform early diagnosis, predict prognosis, and guide treatment decisions. This review shined a spotlight on biology, detection technologies, and propagation platforms for CTCs. Of note, we also reviewed clinical applications of CTCs in liquid biopsy-based personalized cancer treatment and critically appraised limitations in routine clinical practice on the path to precision medicine.
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Affiliation(s)
- Jiani Yang
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shanshan Cheng
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Nan Zhang
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yue Jin
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yu Wang
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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Zhong M, Zhang Y, Pan Z, Wang W, Zhang Y, Weng Y, Huang H, He Y, Liu O. Clinical Utility of Circulating Tumor Cells in the Early Detection of Lung Cancer in Patients with a Solitary Pulmonary Nodule. Technol Cancer Res Treat 2021; 20:15330338211041465. [PMID: 34519585 PMCID: PMC8445525 DOI: 10.1177/15330338211041465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Lung cancer is the most common cancer and can appear as a solitary pulmonary nodule. Early detection of lung cancer in this patient population would be beneficial for the disease management. In this study, the potential application of circulating tumor cells (CTCs) on early detection of lung cancer in this population was investigated. Methods: The number of CTCs in bronchoalveolar lavage fluid and serum levels of tumor-related markers, cancer antigen 125 (CA125), carcinoembryonic antigen (CEA) and neuron-specific enolase (NSE) were measured in patients with a solitary pulmonary nodule. The association between CTCs and lung cancer was examined. The diagnosis performances of CTCs and selected tumor-related markers were compared. Results: The CTC positivity was significantly associated with lung cancer (P = .009). The sensitivity of CTCs and CA125, CEA, NSE, and CA125/CEA/NSE was 75%, 5.6%, 0%, 25%, and 33%, respectively. The sensitivity of CTCs was improved from 75% to 83% by the combination with CA125 or NSE. Conclusion: CTCs may be helpful for the early detection of lung cancer in patients with a solitary pulmonary nodule.
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Affiliation(s)
- Manhua Zhong
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Yi Zhang
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Zuguang Pan
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Wei Wang
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Yuxin Zhang
- The First Clinical College, Southern Medical University, Guangzhou, China
| | - Yuqing Weng
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Haile Huang
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Yanju He
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Ouqi Liu
- Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
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Zhang X, Guo X, Zong Y, Xu C, Wang J, Zhang B, Liu C, Gong Y, Xue L, Ma L, Zhang S, Li Y, Zeng H. CTCs detection from intraoperative salvaged blood in RCC-IVC thrombus patients by negative enrichment and iFISH identification: a preliminary study. BMC Urol 2021; 21:89. [PMID: 34112129 PMCID: PMC8191124 DOI: 10.1186/s12894-021-00803-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intra-operative cell salvage (IOCS) and leukocyte-depleted filter (LDF) are widely used and effective in saving blood. However, the safety issue concerning reinfusion of IOCS-LDF processed blood to renal cell carcinoma (RCC) patients with inferior vena cava (IVC) thrombus were inconclusive for fear of increased risk of cancer metastases. This study intends to analyze the circulating tumor cell (CTC) eliminating effect of IOCS-LDF in 5 RCC-IVC thrombus patients. METHODS A novel strategy integrating negative enrichment by immunomagnetic beads and immunostaining-fluorescence in situ hybridization with probes identifying aneuploid of 8 and/or 7 were used to detect CTCs from salvages blood. Blood samples were collected from 4 stages in each patient. RESULTS Of the 5 RCC patients, the number of CTCs decreased (from 3, 4, 10, 7, 3, respectively, to all zero) after IOCS-LDF treatment. The triploid of chromosome 7 and/or chromosome 8 were most common karyotype for RCC patients with IVC thrombus. Tetraploid of chromosome 8 occurred in only one sample and no polypoid (number of chromosome > 4) were found. CONCLUSION IOCS-LDF might be a promising way of reducing of allogeneic product transfusion based on current preliminary outcome. More convincing conclusions are to be drawn with enlarged sample size and long-term follow-up for patients prognosis.
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Affiliation(s)
- Xiaoqing Zhang
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Xiangyang Guo
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Yanan Zong
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Chuanya Xu
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Jilian Wang
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Bin Zhang
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Chang Liu
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China
| | - Yueqing Gong
- Biological Sample Bank, Peking University Third Hospital, Beijing, China
| | - Lixiang Xue
- Biological Sample Bank, Peking University Third Hospital, Beijing, China
| | - Lulin Ma
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Shudong Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Yi Li
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China.
| | - Hong Zeng
- Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China.
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12
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Du K, Huang Q, Bu J, Zhou J, Huang Z, Li J. Circulating Tumor Cells Counting Act as a Potential Prognostic Factor in Cervical Cancer. Technol Cancer Res Treat 2020; 19:1533033820957005. [PMID: 33034270 PMCID: PMC7549154 DOI: 10.1177/1533033820957005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Circulating tumor cells (CTCs) hold huge potential for both clinical
applications and basic research into the management of cancer, but the
relationship between CTC count and cervical cancer prognosis remains
unclear. Therefore, research on this topic is urgently required. Objective: This study investigated whether CTCs were detectable in patients with
cervical cancer and whether CTC count was an indicator of prognosis. Methods: We enrolled 107 patients with pathologically confirmed cervical cancer. CTCs
were detected after radiotherapy or concurrent cisplatin-containing
chemotherapy in all patients. We evaluated all medical records and imaging
data as well as follow-up information to calculate progression-free survival
(PFS). PFS was defined as the time until first diagnosis of tumor
progression or death. We also analyzed the relationship between CTC count
and patient age, disease stage, histological differentiation, tumor size,
and pathological type. Results: CTCs were identified in 86 of 107 patients (80%), and the CTC count ranged
from 0 to 27 cells in 3.2 mL blood. The median progression-free survival
(PFS) was 43.1 months. Patients in which CTCs were detected had a
significantly shorter PFS than CTC-negative patients (P = 0.018).
Multivariate analysis indicated that CTC count was an independent negative
prognostic factor for survival. However, no correlation was observed between
CTC count and patient age, disease stage, histological differentiation,
tumor size, and pathological type. Conclusion: CTC count is an independent negative prognostic factor for cervical
cancer.
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Affiliation(s)
- Kunpeng Du
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qian Huang
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Junguo Bu
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jieling Zhou
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zijian Huang
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jiqiang Li
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
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13
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Yu H, Ma L, Zhu Y, Li W, Ding L, Gao H. Significant diagnostic value of circulating tumour cells in colorectal cancer. Oncol Lett 2020; 20:317-325. [PMID: 32565958 PMCID: PMC7285991 DOI: 10.3892/ol.2020.11537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/28/2020] [Indexed: 02/05/2023] Open
Abstract
Circulating tumour cells (CTCs) have potential utility in various clinical applications for cancer management. The present study focused on evaluating the diagnostic role of CTCs in colorectal cancer (CRC). A total of 89 blood samples from 59 patients diagnosed with CRC and 30 healthy individuals were collected for CTC detection. The Cyttel method is an improved CTC detection strategy, which combines negative enrichment with immunofluorescence and fluorescence in situ hybridization. This method effectively detected a significant increase in total CTCs in patients with CRC (49/59) compared with those in healthy controls (3/30). A cut-off value of 2 CTCs/3.2 ml blood yielded a sensitivity of 83.05% and a specificity of 100%. Additionally, three traditional serum tumour markers, namely carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9) and CA72-4, were examined by immunoassays. The diagnostic sensitivity of CTCs was much higher than that of CEA, CA19-9 and CA72-4 alone or in combination, particularly in patients with early stage CRC. The combined sensitivity of CTCs and CEA reached 91.53%, which was only slightly lower than the sensitivity of all four markers combined (CTCs + CEA + CA19-9 + CA72-4). CTCs with aneuploidy of chromosome 7 or 8 were carefully distinguished, and the associations among different types of CTCs, clinicopathological characteristics and overall survival were statistically analysed. Total CTCs were revealed to be significantly associated with tumour differentiation and nerve invasion. CTCs were more likely to be detected in poorly differentiated CRC tumours than in well- and moderately-differentiated tumours (P=0.026). Furthermore, to the best of our knowledge, the present study was the first to report that CTCs with multiploidy of chromosome 7 were significantly associated with TNM stage. These CTCs exhibited a high chance of being identified in the peripheral blood of patients with late-stage CRC (stage III–IV; P=0.031). The present study suggests that the combination of CTCs and CEA may serve as an effective potential diagnostic and prognostic indicator in patients with CRC. Detection of CTCs with aneuploidy may have increased specificity in predicting highly malignant and invasive tumours in CRC management.
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Affiliation(s)
- Haijiao Yu
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
| | - Ling Ma
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
| | - Yubing Zhu
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
| | - Wenxia Li
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
| | - Lei Ding
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
| | - Hong Gao
- Department of Colorectal Tumour Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, P.R. China
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14
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Hu B, Tian X, Li Y, Liu Y, Yang T, Han Z, An J, Kong L, Li Y. Epithelial-mesenchymal transition may be involved in the immune evasion of circulating gastric tumor cells via downregulation of ULBP1. Cancer Med 2020; 9:2686-2697. [PMID: 32077634 PMCID: PMC7163085 DOI: 10.1002/cam4.2871] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/24/2022] Open
Abstract
Background Increasing numbers of studies have demonstrated that circulating tumor cells (CTCs) undergo a phenotypic change termed epithelial‐mesenchymal transition (EMT), and researchers have proposed that EMT might provide CTCs with increased potential to survive in the different microenvironments encountered during metastasis through various ways, such as by increasing cell survival and early colonization. However, the exact role of EMT in CTCs remains unclear. Methods In this study, we identified CTCs of 41 patients with gastric cancer using Cyttel‐CTC and im‐FISH (immune‐fluorescence in situ hybridization) methods, and tested the expression of EMT markers and ULBP1 (a major member of the NKG2D—natural killer [NK] group 2 member D—ligand family) on CTCs. Moreover, we investigated the relationship between the expression of EMT markers and ULBP1 on CTCs and gastric cancer cell lines. Results Our results showed that the CTCs of gastric cancer patients exhibited three EMT marker subtypes, and that the expression of ULBP1 was significantly lower on mesenchymal phenotypic CTCs (M+CTCs) than on epithelial phenotypic CTCs (E+CTCs). EMT induced by TGF‐β in vitro produced a similar phenomenon, and we therefore proposed that EMT might be involved in the immune evasion of CTCs from NK cells by altering the expression of ULBP1. Conclusions Our study indicated that EMT might play a vital role in the immune invasion of CTCs by regulating the expression of ULBP1 on CTCs. These findings could provide potential strategies for targeting the immune evasion capacity of CTCs.
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Affiliation(s)
- Baoguang Hu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Xiaokun Tian
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, China.,Department of Burn and Plastic Surgery, the Sixth People's Hospital of Zibo, Zibo, China
| | - Yanbin Li
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Yangchun Liu
- Jiangxi Medical College, Queen Mary College of Nanchang University, Nanchang, China
| | - Tao Yang
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Zhaodong Han
- Department of Clinical Laboratory, Binzhou Medical University Hospital, Binzhou, China
| | - Jiajia An
- Department of Clinical Laboratory, Binzhou Medical University Hospital, Binzhou, China
| | - Lingqun Kong
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Yuming Li
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, China
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15
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Wang PP, Liu SH, Chen CT, Lv L, Li D, Liu QY, Liu GL, Wu Y. Circulating tumor cells as a new predictive and prognostic factor in patients with small cell lung cancer. J Cancer 2020; 11:2113-2122. [PMID: 32127938 PMCID: PMC7052935 DOI: 10.7150/jca.35308] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 12/22/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Small cell lung cancer (SCLC) is the most malignant type of lung cancer characterized by rapid progression, early metastasis and recurrence. In recent years, circulating tumor cells (CTCs) were found to play an important role in tumor invasion, metastasis, recurrence and prognosis. Methods: CTCs were detected in 138 patients with newly diagnosed SCLC from January 2012 to December 2018. Nomogram prediction models were constructed based on prognostic factors screened by multivariate Cox regression analysis and the risk stratification of SCLC patients were performed on basis of nomogram points. A total of 108 patients from January 2012 to December 2016 were assigned to a training group, and 30 patients from January 2017 to December 2018 were included into the validation group for nomogram analysis. This study was approved by ethics committee of Guangzhou First People's Hospital and all subjects provided informed consent. Results: The number of CTCs was associated with age, lymph node metastasis (N), distant metastasis (M), TNM staging, and NSE. The high number of CTC predicted adverse prognosis, and the AUC of time-dependent ROC curve was all high than 0.5. In the training group, after multivariate COX regression screening, the factors in the median survival time (MST) and overall survival (OS) nomogram prediction models were age, TNM, CTC, NSE and treatment mode. The C-index of the nomograms in internal validation for MST and OS was 0.813 and in external validation for MST and OS were 0.885. The AUC of ROC curves for nomogram were high than 0.5. Finally, risk stratification could be effectively performed on the basis of nomogram points. Conclusions: CTC can be served as a predictive and prognostic factor for SCLC, and the nomogram models constructed by CTC and multiple clinical parameters can comprehensively predict the prognosis of SCLC patients and perform risk stratification.
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Affiliation(s)
- Pei-Pei Wang
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Si-Hong Liu
- Department of Orthopaedics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Cun-Te Chen
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Lin Lv
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Dan Li
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Qiong-Yao Liu
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Guo-Long Liu
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
| | - Yong Wu
- Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China, 510180
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16
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Asante DB, Calapre L, Ziman M, Meniawy TM, Gray ES. Liquid biopsy in ovarian cancer using circulating tumor DNA and cells: Ready for prime time? Cancer Lett 2019; 468:59-71. [PMID: 31610267 DOI: 10.1016/j.canlet.2019.10.014] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/06/2019] [Indexed: 01/06/2023]
Abstract
Liquid biopsies hold the potential to inform cancer patient prognosis and to guide treatment decisions at the time when direct tumor biopsy may be impractical due to its invasive nature, inaccessibility and associated complications. Specifically, circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) have shown promising results as companion diagnostic biomarkers for screening, prognostication and/or patient surveillance in many cancer types. In ovarian cancer (OC), CTC and ctDNA analysis allow comprehensive molecular profiling of the primary, metastatic and recurrent tumors. These biomarkers also correlate with overall tumor burden and thus, they provide minimally-invasive means for patient monitoring during clinical course to ascertain therapy response and timely treatment modification in the context of disease relapse. Here, we review recent reports of the potential clinical value of CTC and ctDNA in OC, expatiating on their use in diagnosis and prognosis. We critically appraise the current evidence, and discuss the issues that still need to be addressed before liquid biopsies can be implemented in routine clinical practice for OC management.
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Affiliation(s)
- Du-Bois Asante
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Leslie Calapre
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Melanie Ziman
- School of Medical and Health Sciences, Edith Cowan University, Australia; School of Biomedical Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Tarek M Meniawy
- School of Medical and Health Sciences, Edith Cowan University, Australia; School of Medicine, University of Western Australia, Crawley, Western Australia, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Elin S Gray
- School of Medical and Health Sciences, Edith Cowan University, Australia.
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17
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Wu X, Yang C, Yu H, Cao F, Shan Y, Zhao W. The predictive values of serum dickkopf-1 and circulating tumor cells in evaluating the efficacy of transcatheter arterial chemoembolization treatment on hepatocellular carcinoma. Medicine (Baltimore) 2019; 98:e16579. [PMID: 31348291 PMCID: PMC6709003 DOI: 10.1097/md.0000000000016579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this study, we aim to explore the values of serum dickkopf-1 (DKK1) and circulating tumor cells (CTCs) in predicting the efficacy and prognosis of transcatheter arterial chemoembolization (TACE) treatment on patients with hepatocellular carcinoma (HCC). We did a retrospective analysis on 155 HCC patients who underwent TACE treatment. The patients were divided into response group (complete response and partial response) and nonresponse group (stable disease and progressive disease), and their changes in serum DKK1 and CTCs after TACE were recorded. Receiver operating characteristic curve and survival analysis were used to assess the predictive values of DKK1 and CTCs for TACE efficacy and long-term prognosis of HCC. We found that the levels of preoperative DKK1 and CTCs in patients with HCC had a moderate positive correlation (r = 0.54). After TACE treatment, the serum DKK1 and CTCs in the response group were significantly decreased compared to pretreatment levels (P < .05), whereas the nonresponse group showed significantly increased serum DKK1 and CTCs levels (P < .05). The largest area under the curve (AUC) was achieved when using >0.02 μg/L reduction in DKK1 level after 4 weeks of TACE to predict the efficacy of TACE treatment (AUC = 0.913, 95% confidence interval: 0.856-0.952, P < .001), with the sensitivity of 78.26% and the specificity of 88.07%. The overall survival, disease-free survival, and 5-year survival rates were all significantly lower in the patients with positive preoperative levels of serum DKK1 and CTCs. COX multivariate regression analysis showed that Eastern Cooperative Oncology Group score, and preoperative levels of serum DKK1 and CTCs are independent influencing factors for the prognosis of patients with HCC. Overall, our results demonstrated that serum DKK1 and CTCs levels were good biomarkers for predicting the efficacy and prognosis of TACE treatment in patients with HCC. Moreover, these parameters exhibited different characteristics, and might have different potential applications.
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Affiliation(s)
- Xiaoxia Wu
- Department of Oncology, Wuxi Fifth People's Hospital, Wuxi
| | - Chao Yang
- Department of Interventional Radiology
| | - Hao Yu
- Department of Oncology, Wuxi Fifth People's Hospital, Wuxi
| | - Fei Cao
- Department of Oncology, Wuxi Fifth People's Hospital, Wuxi
| | - Yongfeng Shan
- Department of Oncology, Wuxi Fifth People's Hospital, Wuxi
| | - Weifeng Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
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18
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Li Y, Tian X, Gao L, Jiang X, Fu R, Zhang T, Ren T, Hu P, Wu Y, Zhao P, Yang D. Clinical significance of circulating tumor cells and tumor markers in the diagnosis of lung cancer. Cancer Med 2019; 8:3782-3792. [PMID: 31132233 PMCID: PMC6639255 DOI: 10.1002/cam4.2286] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 01/05/2023] Open
Abstract
Background Lung cancer has the highest fatality rate of all cancer types. To improve patients’ survival and life quality, it is therefore very important to screen for and detect it at an early stage. Methods A negative enrichment–fluorescence in situ hybridization (NE‐FISH) approach was used to detect circulating tumor cells (CTCs) in lung cancer patients, and levels of lung cancer‐associated serum markers were also measured in the peripheral blood of these same patients. The correlation between CTCs, serum cancer markers (carcinoembryonic antigen [CEA], CA 125, CYFRA 21‐1, and SCC), and clinicopathological characteristics was then investigated. Moreover, the potential clinical use of the combination of CTCs and tumor markers for the diagnosis of lung cancer, especially at early stages, was also explored. Results CTC frequencies in lung cancer patients were significantly higher than in healthy control volunteers or patients with benign lung disease, and the area under the receiver operating characteristics curve for the control group was 0.846 (95% CI 0.796‐0.887, P < 0.001). The rate of CTC positivity in lung cancer patients was 68.29% when the CTC cutoff value was 2, and the sensitivity of this means of lung cancer detection rose to 82.93% by combining CTC‐based detection with measurements of serum tumor markers. Similarly, the diagnostic sensitivity of this approach in early‐stage lung cancer patients (I‐II) was improved from 63.93% to 78.69%. Detection of CTCs can thus assist with the identification of benign and malignant pulmonary nodules. Conclusions It is potentially helpful and effective to employ a combination of CTCs and serum tumor markers for the clinical diagnosis of lung cancer.
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Affiliation(s)
- Yang Li
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Xudong Tian
- Department of Thoracic Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Lei Gao
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Xiaohong Jiang
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Rao Fu
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Tingting Zhang
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Tianying Ren
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Ping Hu
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Yaping Wu
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Peige Zhao
- Department of Respiratory Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Dawei Yang
- Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China
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Ye Y, Li SL, Wang JJ, Liu B. The diagnostic value of circulating tumor cells for lung cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e14936. [PMID: 30896658 PMCID: PMC6709102 DOI: 10.1097/md.0000000000014936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Circulating tumor cells (CTCs) have become a potential diagnostic tumor marker and have the potential for wide clinical applications. However, the diagnostic parameters vary among previous studies. A systematic review of the literature and meta-analysis were conducted to assess the diagnostic value of CTCs for lung cancer. METHODS Eligible studies were searched in PubMed, Medline, Cochrane Library, and Embase databases. The included studies assessed the diagnostic value of CTCs in patients with lung cancer up to September 30, 2018. A total of 1601 patients in 8 studies were included in the meta-analysis. We calculated the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) to investigate the diagnostic value of CTCs for lung cancer. STATA version 12.0 and Meta-DiSc version 1.4 software were used to analyze the data. RESULTS The pooled sensitivity was 0.75 (95% CI: 0.73-0.78), the specificity was 0.89 (95% CI: 0.86-0.92), the PLR was 6.29 (95% CI: 3.98-9.96), and the NLR was 0.24 (95% CI: 0.14-0.42). Furthermore, the pooled DOR of CTCs for lung cancer was 27.73 (95% CI: 12.99-59.23). The summarized area under the ROC curve was 0.93 (95% CI: 0.90-0.95). The meta-regression analysis suggested that the heterogeneity was mainly attributed to the experimental methods. The results of the clinical diagnosis efficiency show that the diagnostic efficiency has increased significantly by testing CTCs for diagnosing lung cancer. CONCLUSION The results of this meta-analysis suggest that CTCs are associated with a high diagnostic value for lung cancer. These findings require large-scale prospective studies to verify and evaluate the diagnostic value in the future.
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Affiliation(s)
- Yun Ye
- Department of Laboratory Medicine
| | | | - Jian-Jun Wang
- Emergency Department, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Bing Liu
- Department of Laboratory Medicine
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20
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Improvement of sensitive and specific detection of circulating tumor cells using negative enrichment and immunostaining-FISH. Clin Chim Acta 2018; 485:95-102. [DOI: 10.1016/j.cca.2018.06.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 02/07/2023]
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21
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Liu X, Zhang Z, Zhang B, Zheng Y, Zheng C, Liu B, Zheng S, Dong K, Dong R. Circulating tumor cells detection in neuroblastoma patients by EpCAM-independent enrichment and immunostaining-fluorescence in situ hybridization. EBioMedicine 2018; 35:244-250. [PMID: 30104180 PMCID: PMC6154868 DOI: 10.1016/j.ebiom.2018.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/17/2022] Open
Abstract
Detecting circulating tumor cells (CTCs) has proven valuable for evaluating the prognosis of cancer patients and for studying the mechanisms of treatment resistance. Owing to the lack of universal and specific tumor markers for neuroblastoma (NB), in this prospective study, we adopted an EpCAM-independent method to detect CTCs in the peripheral blood of NB patients. We used an EpCAM-independent assay to delete leukocytes and to enrich the CTCs. CTCs were identified by immunostaining of CD45, DAPI and DNA fluorescence in situ hybridization (FISH) of the centromere of chromosome 8 probe (CEP8). Cells that were DAPI+/CD45-/CEP8 ≥ 3 were considered CTCs. We collected peripheral blood from 28 NB patients as well as clinical and follow-up data. The number of CTCs among the different risk groups were significantly different (p = .0208, Kruskal–Wallis test). Patients with metastasis had more CTCs than those without metastasis (p < .0001, Mann–Whitney test). Patients with ≥3 CTCs per 4 ml of peripheral blood had an increased likelihood of having metastasis (sensitivity, 88.89%; specificity, 78.59%), and patients with ≥10 CTCs per 4 ml of peripheral blood had poorer overall survival. The EpCAM-independent assay along with immunostaining-FISH (i-FISH) described here can detect CTCs in patients with NB at a high sensitivity and may have clinical value for prognosis evaluation and diagnosing metastasis when imaging data are ambiguous.
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Affiliation(s)
- Xiangqi Liu
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China
| | - Zhenzhen Zhang
- Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine, Shanghai, China
| | - Binbin Zhang
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China
| | - Yijie Zheng
- Medical Scientific Liaison Asian Pacific, Abbott Diagnostics Division, Abbott Laboratories, Shanghai, China
| | - Chao Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China
| | - Baihui Liu
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China
| | - Shan Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China
| | - Kuiran Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China.
| | - Rui Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China.
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22
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Zhong CH, Tong D, Zhou ZQ, Su ZQ, Luo YL, Xing J, Bai YL, Guo SJ, Li SY. Performance evaluation of detecting circulating tumor cells and tumor cells in bronchoalveolar lavage fluid in diagnosis of peripheral lung cancer. J Thorac Dis 2018; 10:S830-S837. [PMID: 29780629 DOI: 10.21037/jtd.2017.12.125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background To evaluate the diagnostic performances of detecting circulating tumor cells (CTCs) and tumor cells in bronchoalveolar lavage fluid (BALF) for peripheral lung cancer. Methods A total of 247 patients with lung cancer and 70 cases with benign lung disease were recruited in this study. Peripheral blood and BALF samples were collected, in which the tumor cells were enriched by negative immunomagnetic selection and detected by fluorescence in situ hybridization (FISH) of chromosome enumeration probe 8 (CEP8). The levels of tumor-associated markers (e.g., CEA, CA125, and NSE) in peripheral blood plasma were measured by using electrochemiluminescence. Results The numbers of CTCs detected in peripheral blood were significantly higher in patients with lung cancer than those with benign lung disease (5.78±0.57 vs. 1.13±0.39, Z=-8.64, P<0.01). Similarly, tumor cells count in BALF of malignancy were higher than that of benign lesions (6.76±0.89 vs. 0.89±0.23, Z=-6.254, P<0.01). However, as for patients with lung cancer and benign lung disease, the numbers of tumor cells in peripheral blood were comparable with those in BALF (both P>0.05). Detecting CTCs and tumor cells in BALF had similar areas under curves (AUC =0.871 and 0.963, respectively; P>0.05) in discriminating benign lesions from lung cancer (sensitivity 83.8% and 92.6%, specificity 86.5% and 99.9%, respectively), both of which were larger than those of NSE, CEA, and CA125 (AUC =0.564, 0.512 and 0.554, respectively; all P<0.05). The diagnostic performances of discriminating benign lesions and lung cancer in BALF and peripheral blood were both in concordance with that of histopathology (kappa values 0.662 and 0.569, respectively; both P<0.001). Conclusions Detecting tumor cells in peripheral blood and BALF may sensitive to identify benign and malignant peripheral lung lesions and be of value for early diagnosis of lung cancer.
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Affiliation(s)
- Chang-Hao Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Da Tong
- Department of Respiratory Medicine, Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, China
| | - Zi-Qing Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Zhu-Quan Su
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Yu-Long Luo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Jia Xing
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Peking Union Medical College, Kunming 650118, China
| | - Ya-Li Bai
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Peking Union Medical College, Kunming 650118, China
| | - Su-Jie Guo
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Peking Union Medical College, Kunming 650118, China
| | - Shi-Yue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Chen Z, Xu L, Xu X, Yuan C. The clinical value of detecting circulating tumour cells in the peripheral blood of nasopharyngeal carcinoma patients. Oncol Lett 2018; 15:6283-6290. [PMID: 29731846 PMCID: PMC5921240 DOI: 10.3892/ol.2018.8155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 02/13/2018] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study as to analyse the associations between circulating tumour cells (CTCs) and the clinical parameters of nasopharyngeal carcinoma (NPC). Peripheral blood (7.5 ml) from 68 first-diagnosed NPC patients was collected to detect and identify CTCs by cluster of differentiation (CD)45 immunomagnetic separation. Immunofluorescent staining of cytokeratin-18, CD45 and DAPI, and fluorescence in situ hybridization were combined with the centromere of chromosome 8 (CEP8) probe method to analyse the associations between CTCs and clinical parameters. One-year follow-up of the NPC patients who received standardized treatment was also performed to analyse the associations between CTCs, tumour development and the treatment effect. The detection rate of CTCs in the 68 NPC patients was 98.5% and the positive rate of CTCs was 60.3%. The positive rates of CTCs in the I–III and IV stage patients were 51.1 and 78.3%, respectively; the rate was 90.0% in the M1 stage and 55.2% in the M0 stage. The differences were statistically significant (P<0.05). The mean CTC counts were 3.86±2.36 and 5.70±2.91 in the M0 and M1 stages, respectively, which was significantly different (P=0.031). The 12-month follow-up record suggested tumour progression for 17 patients, and the one-year progress free survival rate was 74.6%. Among the CTC-positive stages III–IV patients, the disease progression rate of the patients who had received treatment including chemotherapy/intensity-modulated radiation therapy (IMRT) was 83.3%, which was higher than that of the patients who received treatment including chemotherapy/IMRT/chemotherapy, and the difference was statistically significant (P<0.05). The results of the present study suggested that CTCs were closely associated with the stages of NPC. The later clinical stages may have higher CTC-positive rates for NPC. Treatment with chemotherapy/IMRT/chemotherapy may be more effective for CTC-positive patients in stages III–IV than the use of chemotherapy/IMRT.
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Affiliation(s)
- Zhuo Chen
- Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Lu Xu
- Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Xinhua Xu
- Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Chen Yuan
- Department of Oncology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei 443003, P.R. China
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Guo YX, Neoh KH, Chang XH, Sun Y, Cheng HY, Ye X, Ma RQ, Han RPS, Cui H. Diagnostic value of HE4+ circulating tumor cells in patients with suspicious ovarian cancer. Oncotarget 2018; 9:7522-7533. [PMID: 29484129 PMCID: PMC5800921 DOI: 10.18632/oncotarget.23943] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022] Open
Abstract
Lacking a satisfactory screening test, ovarian cancer is frequently diagnosed at a late stage, leading to poor patient outcomes. This study investigated the diagnostic value of circulating tumor cells (CTCs) in peripheral blood from patients with suspected ovarian tumors. Sixty-one women suspected of having an ovarian mass were prospectively enrolled in this study. CTCs were identified and counted using microfluidic isolation and immunofluorescent staining of CD45, HE4, and epithelial and mesenchymal (E&M) markers (epithelial cell adhesion molecule, cytokeratins, and vimentin). Thirty (49%) of the patients were diagnosed with ovarian cancer. DAPI+/E&M+/CD45-/HE4+ CTC counts were higher in these patients than in patients with benign tumors (p = 0.016). The receiver operating characteristic (ROC) curve showed that the sensitivity of CTCs was 73.3%, which was superior to that of CA125 (56.7%). In patients with elevated CA125 levels (≥35 U/ml), CTC counts still showed good specificity (86.7%). Our findings suggest the DAPI+/E&M+/CD45-/HE4+ CTC count is a useful diagnostic indicator in patients with suspected ovarian cancer.
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Affiliation(s)
- Yan-Xiu Guo
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
| | | | - Xiao-Hong Chang
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
| | - Yukun Sun
- College of Engineering, Peking University, Beijing, China
| | - Hong-Yan Cheng
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
| | - Xue Ye
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
| | - Rui-Qiong Ma
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
| | - Ray P S Han
- College of Engineering, Peking University, Beijing, China
| | - Heng Cui
- Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China
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Sun B, Liu H, Wang S, Xiang J, Liu X. Prognostic impact of circulating tumor cells in patients with ampullary cancer. J Cell Physiol 2018; 233:5014-5022. [PMID: 29215725 PMCID: PMC5873396 DOI: 10.1002/jcp.26353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/30/2017] [Indexed: 12/16/2022]
Abstract
Circulating tumor cells (CTCs) are an important topic of investigation for both basic and clinical cancer research. In this prospective study, we evaluated the clinical role of CTCs in ampullary cancer. We analyzed blood samples from 62 consecutively diagnosed patients with ampullary adenocarcinoma and 24 healthy controls for their CTC content. Combined data from immunostaining of CD45, 4',6-diamidino-2-phenylindole (DAPI), and fluorescence in situ hybridization with a chromosome 8 centromere (CEP8) probe were used to identify CTCs; cells that were CD45-/DAPI+/CEP8>2 were considered CTCs. The Cox proportional hazards model was used to assess the relationship between CTCs, clinical characteristics, and patient outcomes. We detected ≥2 CTCs/3.2 ml whole blood in 43 of 62 patients (69.4%), as well as ≥5 CTCs/3.2 ml in 16 of these patients (25.8%). A CTC cutoff value of 2 cells/3.2 ml achieved 69.4% sensitivity and 95.8% specificity as a diagnostic tool; CTCs were associated with tumor burden. CTC levels ≥3/3.2 ml (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: (1.2-5.2), p = 0.014) and ≥5/3.2 ml (HR: 3.5, 95% CI: 1.7-7.3, p < 0.001) were both associated with shorter disease-free survival. Moreover, ≥3 CTCs/3.2 ml (HR: 2.7, 95% CI: 1.2-6.3, p = 0.019) and ≥5 CTCs/3.2 ml (HR: 3.8, 95% CI: 1.8-8.5, p < 0.001) were predictive of shorter overall survival. CTC assessment may help identify patients with ampullary cancer who are at high risk of an unfavorable outcome.
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Affiliation(s)
- Bo Sun
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Han Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shengnan Wang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianbin Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xingdang Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Tong B, Xu Y, Zhao J, Chen M, Xing J, Zhong W, Wang M. Prognostic significance of circulating tumor cells in non-small cell lung cancer patients undergoing chemotherapy. Oncotarget 2017; 8:86615-86624. [PMID: 29156821 PMCID: PMC5689711 DOI: 10.18632/oncotarget.21255] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/23/2017] [Indexed: 01/06/2023] Open
Abstract
The utility of circulating tumor cells (CTCs) as prognostic biomarkers in non-small cell lung cancer (NSCLC) is inconclusive due to the limitations of current CTC detection methods. Using a novel high-efficiency detection method, we determined the ability of CTCs to predict survival and chemotherapeutic responses in NSCLC. In 127 patients with advanced NSCLC, CTCs were counted and analyzed at baseline and during follow-up. Median overall survival (OS) and progression-free survival (PFS) were longer in patients with baseline CTC counts <8 CTCs/3.2 mL (20.0 vs. 10.4 months [P = 0.009] and 7.2 vs. 5.5 months [P < 0.001], respectively). Patients with post-treatment increases in the CTC count had poorer OS and PFS than those without increases (12.0 vs. 13.3 months [P = 0.028] and 5.2 vs. 6.4 months [P = 0.022], respectively). There was no association between the baseline CTC count and chemotherapeutic response (P = 0.734). However, the rate of progressive disease in patients with and without post-treatment increases in the CTC count were 15.6% and 2.4% (P = 0.042), respectively. The baseline CTC count and the change in the CTC count during treatment were both valuable prognostic indicators for NSCLC.
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Affiliation(s)
- Bing Tong
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
| | - Yan Xu
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
| | - Jing Zhao
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
| | - Minjiang Chen
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
| | - Jia Xing
- Cyttel Biosciences Inc., Beijing, 101111 P.R. China
| | - Wei Zhong
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
| | - Mengzhao Wang
- Department of Respiratory Medicine, Lung Cancer Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 P.R. China
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27
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He Y, Shi J, Shi G, Xu X, Liu Q, Liu C, Gao Z, Bai J, Shan B. Using the New CellCollector to Capture Circulating Tumor Cells from Blood in Different Groups of Pulmonary Disease: A Cohort Study. Sci Rep 2017; 7:9542. [PMID: 28842574 PMCID: PMC5572713 DOI: 10.1038/s41598-017-09284-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/26/2017] [Indexed: 02/03/2023] Open
Abstract
Circulating tumor cells (CTCs) are promising biomarkers for clinical application. Cancer screening with Low-Dose Computed Tomography (LDCT) and CTC detections in pulmonary nodule patients has never been reported. The aim of this study was to explore the effectiveness of the combined methods to screen lung cancer. Out of 8313 volunteers screened by LDCT, 32 ground-glass nodules (GGNs) patients and 19 healthy volunteers were randomly selected. Meanwhile, 15 lung cancer patients also enrolled. CellCollector, a new CTC capturing device, was applied for CTCs detection. In GGNs group, five CTC positive patients with six CTCs were identified, 15.6% were positive (range, 1–2). In lung cancer group, 73.3% of the analyzed CellCollector cells were positive (range, 1–7) and no “CTC-like” events were detected in healthy group. All CTCs detected from GGNs group were isolated from the CellCollector functional domain and determined by whole genomic amplification for next-generation sequencing(NGS) analysis. NGS data showed that three cancer-related genes contained mutations in five CTC positive patients, including KIT, SMARCB1 and TP53 genes. In four patients, 16 mutation genes existed. Therefore, LDCT combined with CTC analysis by an in vivo device in high-risk pulmonary nodule patients was a promising way to screen early stage lung cancer.
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Affiliation(s)
- Yutong He
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Jin Shi
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Gaofeng Shi
- Department of Radiology, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Xiaoli Xu
- Follow-up Centre, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Qingyi Liu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Congmin Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Zhaoyu Gao
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China
| | - Jiaoteng Bai
- Hebei Viroad Biotechnology Co., Ltd, Shijiazhuang, 050011, Hebei, China
| | - Baoen Shan
- Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050011, P.R. China.
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Yong C, Min LF, Yang JJ, Xu WJ, Bian JR, Jun L, Zhang XZ, Xu XX. Clinical significance of tumor cells and CD133+
cells from malignant pleural effusion in patients with lung cancer. PRECISION RADIATION ONCOLOGY 2017. [DOI: 10.1002/pro6.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Chen Yong
- Department of Medical Oncology, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Ling-feng Min
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Jun-jun Yang
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Wen-jing Xu
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Jia-rong Bian
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Li Jun
- Department of Medical Oncology, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Xi-zhi Zhang
- Department of Medical Oncology, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
| | - Xing-xiang Xu
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital; Clinical Medical College of Yangzhou University; Yangzhou Jiangsu China
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Zhang H, Gao P, Xiao X, Heger M, Geng L, Fan B, Yuan Y, Huang C, Chen G, Liu Y, Hu Y, Yu X, Wu S, Wang L, Wang Z. A liquid biopsy-based method for the detection and quantification of circulating tumor cells in surgical osteosarcoma patients. Int J Oncol 2017; 50:1075-1086. [PMID: 28350107 PMCID: PMC5363882 DOI: 10.3892/ijo.2017.3905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/14/2017] [Indexed: 11/06/2022] Open
Abstract
A method for the enumeration and quantification of osteosarcoma (OS) circulating tumor cells (CTCs) is currently not available. A correlation between the number of CTCs and progression-free survival (PFS) has been established for other cancers, but not for OS CTCs. A method was therefore developed for CTC quantification in OS and validated in a prospective cohort of surgical patients with primary and recurrent/metastatic OS (N=23). Human OS cells, acting as CTCs, were enumerated from spiked human peripheral blood (PB) following erythrocyte and leukocyte depletion. The OS cells were quantified microscopically based on aneuploidy and a CK18-/CD45- phenotype. Aneuploidy was assayed by fluorescence in situ hybridization (FISH) using fluorescence-labeled alpha-satellite probes for the centromeres of chromosome (CEP 8). CK18 and CD45 phenotyping was performed with immunocytochemistry. HOS cells in spiked PB could be effectively retrieved with the FISH-based enumeration method, which was subsequently employed in an OS patient cohort. PB of recurrent/metastatic OS patients contained more CTCs than the PB of primary OS patients. OS patients with ≥2 CTCs per 7.5 ml of PB had worse PFS than patients whose PB contained <2 CTCs. In 2 cases, CTCs were present in PB of OS patients with negative X-ray and chest CT scans. In conclusion, our method was able to quantitate CTCs in liquid biopsies of OS patients. The number of CTCs has diagnostic and prognostic value.
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Affiliation(s)
- Haoqiang Zhang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Peng Gao
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Xin Xiao
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Michal Heger
- Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Lei Geng
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Bo Fan
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yulin Yuan
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Chen Huang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Guojing Chen
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yao Liu
- Membrane Biochemistry and Biophysics, Institute of Biomembranes, Utrecht University, 3584CH Utrecht, The Netherlands
| | - Yongchen Hu
- Department of Orthopedic Oncology, Tianjin Hospital, Tianjin 300210, P.R. China
| | - Xiuchun Yu
- Department of Orthopedics, The General Hospital of Jinan Military Commanding Region, Jinan, Shandong 250031, P.R. China
| | - Sujia Wu
- Department of Orthopedics, The General Hospital of Nanjing Military Commanding Region, Nanjing, Jiangsu 210008, P.R. China
| | - Ling Wang
- Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Zhen Wang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Cunnea P, Gowers S, Moore JE, Drakakis E, Boutelle M, Fotopoulou C. Review article: Novel technologies in the treatment and monitoring of advanced and relapsed epithelial ovarian cancer. CONVERGENT SCIENCE PHYSICAL ONCOLOGY 2017. [PMID: 29515912 DOI: 10.1088/2057-1739/aa5cf1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Epithelial Ovarian cancer (EOC) is the fifth most common cause of cancer death in females in the UK. It has long been recognized to be a set of heterogeneous diseases, with high grade serous being the most common subtype. The majority of patients with EOC present at an advanced stage (FIGO III-IV), and have the largest risk for disease recurrence from which a high percentage will develop resistance to chemotherapy. Despite continual advances in diagnostics, imaging, surgery and treatment of EOC, there has been little variation in the survival rates for patients with EOC. In this review we will introduce novel bioengineering advances in modelling the lymphatic system and real-time tissue monitoring to improve the clinical and therapeutic outcome for patients with EOC. We discuss the advent of the non-invasive "liquid biopsy" in the surveillance of patients undergoing treatment and follow-up. Finally, we present new bioengineering advances for palliative care of patients to lessen symptoms of patients with ascites and improve quality of life.
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Affiliation(s)
- Paula Cunnea
- Department of Surgery and Cancer, Imperial College London
| | - Sally Gowers
- Department of Bioengineering, Imperial College London
| | - James E Moore
- Department of Bioengineering, Imperial College London
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31
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Current and future role of circulating tumor cells in patients with epithelial ovarian cancer. Eur J Surg Oncol 2016; 42:1772-1779. [DOI: 10.1016/j.ejso.2016.05.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/01/2016] [Accepted: 05/11/2016] [Indexed: 12/25/2022] Open
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Huang H, Shi Y, Huang J, Wang X, Zhang R, Chen H. Circulating tumor cells as a potential biomarker in diagnosis of lung cancer: a systematic review and meta-analysis. CLINICAL RESPIRATORY JOURNAL 2016; 12:639-645. [PMID: 27778482 DOI: 10.1111/crj.12573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/19/2016] [Accepted: 09/28/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Accumulating evidences demonstrated that circulating tumor cells (CTCs) show significant high concentration in plasma of lung cancer patients compared to control cohorts, suggesting that CTCs may be a promising biomarker for lung cancer. The meta-analysis was used to evaluate potential diagnostic value of CTCs in diagnosing lung cancer. METHODS Relevant literatures were searched in PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang Data. Summary estimates were used to evaluate CTCs as the diagnostic standard for lung cancer using Meta-DiSc and STATA 12.0 statistical software. RESULTS This meta-analysis included five studies with a total of 460 lung cancer patients and 239 benign controls. The sensitivity and specificity (95% confidence interval [CI]) of CTCs was 75% (95% CI: 54%-88%) and 92% (95%CI: 82%-97%), respectively. In addition, the area under the summary ROC curve (AUC) was 0.93. CONCLUSION CTCs is a novel potential biomarker in the diagnosis of lung cancer, and more prospective are needed in the future.
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Affiliation(s)
- Huang Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China
| | - Yan Shi
- Chinese Orthopaedics and Traumatology, Heilongjiang University of Chinese Medicine, China
| | - Jietao Huang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, China
| | - Xiaohui Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China
| | - Rui Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China
| | - Hong Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China
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Gao Y, Zhu Y, Zhang Z, Zhang C, Huang X, Yuan Z. Clinical significance of pancreatic circulating tumor cells using combined negative enrichment and immunostaining-fluorescence in situ hybridization. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2016; 35:66. [PMID: 27066900 PMCID: PMC4828870 DOI: 10.1186/s13046-016-0340-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/04/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Circulating tumor cells (CTCs) hold great potential in both clinical application and basic research for the managements of cancer. However, it remains to be an enormous challenge to obtain efficient detection of pancreatic CTCs. New detection platforms for the detection of pancreatic CTCs are urgently required. METHODS In the present study, we applied a newly-developed platform integrated subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) to analyze clinical significance of pancreatic CTCs. Immunostaining of CK, CD45, DAPI and FISH with the centromere of chromosome 8 (CEP8) were utilized to identify CTCs. Cells with features of CK+/CD45-/DAPI+/CEP8 = 2, CK+/CD45-/DAPI+/CEP8 > 2, CK-/CD45-/DAPI+/CEP8 > 2 were defined as pancreatic CTCs. The Kaplan-Meier method and Cox proportional hazards model were used to analyze the relationship of CTC level and other clinicopathological factors with pancreatic cancer clinical outcomes. RESULTS CTC count in pancreatic cancer was higher than healthy individuals (median, 3 vs. 0 per 7.5 ml; P < 0.001). SE-iFISH platform yielded a sensitivity of 88% and specificity of 90% in pancreatic cancer at the cutoff value of 2 cells/7.5 ml. Pancreatic cancer patients with lower CTC count (<3/7.5 ml) had substantially better overall survival (OS) compared with these with higher CTC count (≥3/7.5 ml) (15.2 vs. 10.2 months, P = 0.023). Multivariate analysis indicated that higher CTC count was a strong indicator for worse OS (HR = 4.547, P = 0.016). CONCLUSION Our current data showed that CTCs could be detected in pancreatic cancer patients in various stages, whether localized, locally advanced and metastatic. Besides, CTCs have shown the potential implication in predicting prognosis of pancreatic cancer.
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Affiliation(s)
- Yang Gao
- Department of General Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, No.600, Yishan Road, Shanghai, 200233, China
| | - Yayun Zhu
- Department of General Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, No.600, Yishan Road, Shanghai, 200233, China
| | - Zhenzhen Zhang
- Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine, Shanghai, China
| | - Cheng Zhang
- Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine, Shanghai, China
| | - Xinyu Huang
- Department of General Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, No.600, Yishan Road, Shanghai, 200233, China
| | - Zhou Yuan
- Department of General Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, No.600, Yishan Road, Shanghai, 200233, China.
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Zhang Z, Xiao Y, Zhao J, Chen M, Xu Y, Zhong W, Xing J, Wang M. Relationship between circulating tumour cell count and prognosis following chemotherapy in patients with advanced non-small-cell lung cancer. Respirology 2015; 21:519-25. [PMID: 26661896 DOI: 10.1111/resp.12696] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE This study investigated whether circulating tumour cells (CTC) are detectable in patients with non-small cell lung cancer (NSCLC) and whether CTC count could provide prognostic information or serve as an indicator of patient response to chemotherapy. METHODS We enrolled 46 patients with newly diagnosed or recurrent NSCLC. CTC were measured at baseline in all patients and in 23 patients, CTC were also measured before every chemotherapy cycle. The relationship between CTC count and tumour size was analysed. RESULTS CTC were present in 40 patients (87%); among them, 29 (63%) had a CTC count of ≥3 cells/3.2 mL, 17 (37%) had a CTC count of ≥5 cells/3.2 mL and 7 (15.2%) had a CTC count of ≥8 cells/3.2 mL. The median progression-free survival (PFS) and overall survival (OS) were 7.3 months and 16 months, respectively. A CTC count of more than eight prior to chemotherapy was a strong predictor of reduced PFS (P = 0.018) and OS (P = 0.026). A multivariate analysis indicated that baseline CTC count was an independent negative prognostic factor for survival. However, no correlation was observed between CTC count and tumour size after two chemotherapy cycles, its relationship with chemotherapy response still needs to be defined. CONCLUSION Baseline CTC count is an independent negative prognostic factor for NSCLC; The relationship of CTC and survival after chemotherapy still needs to be defined.
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Affiliation(s)
- Zixuan Zhang
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Xiao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Zhao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Minjiang Chen
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Zhong
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Xing
- Cyttel Biosciences INC, Beijing, China
| | - Mengzhao Wang
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Circulating tumor cells in lung cancer: detection methods and clinical applications. Lung 2015; 193:157-71. [PMID: 25690734 DOI: 10.1007/s00408-015-9697-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 02/09/2015] [Indexed: 12/26/2022]
Abstract
Circulating tumor cells (CTCs) are tumor cells that have disseminated from primary and metastatic sites, and circulate in the bloodstream. Advanced immunological and molecular-based methods can be used to detect and analyze the cells with the characteristics of tumor cells, and can be detected and analyzed in the blood of cancer patients. The most commonly used methods in lung cancer combine the processes of immunomagnetic enrichment and immunocytochemical detection, morphology-based enrichment coupled with reverse transcriptase polymerase chain reaction (RT-PCR), and RT-PCR alone. CTC analysis is considered a liquid biopsy approach for early diagnosis, risk stratification, evaluation of curative efficacy, and early detection of lung cancer relapse. In this review, we discuss the present techniques for analyzing CTCs, and the restrictions of using these methods in lung cancer. We also review the clinical studies in lung cancer and discuss the underlying associations between these studies and their future applications to this disease.
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Chen YY, Xu GB. Effect of circulating tumor cells combined with negative enrichment and CD45-FISH identification in diagnosis, therapy monitoring and prognosis of primary lung cancer. Med Oncol 2014; 31:240. [DOI: 10.1007/s12032-014-0240-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 09/05/2014] [Indexed: 01/06/2023]
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Zhang Y, Wang F, Ning N, Chen Q, Yang Z, Guo Y, Xu D, Zhang D, Zhan T, Cui W. Patterns of circulating tumor cells identified by CEP8, CK and CD45 in pancreatic cancer. Int J Cancer 2014; 136:1228-33. [PMID: 25042121 DOI: 10.1002/ijc.29070] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 06/30/2014] [Indexed: 12/12/2022]
Abstract
To improve the identification for CTCs with weak or negative CK and diploid CTCs in pancreatic cancer, we combined immune-staining of CK, CD45, DAPI and fluorescence in situ hybridization with the centromere of chromosome 8 (CEP8) probe method. CTCs in 3.75 mL of blood were depleted for CD45 positive cells with anti-CD45 antibodies and identified by combining CK, CD45, DAPI and CEP8 in 61 cases including 22 pancreatic cancers, 3 borderline pancreatic solid pseudopapillary tumors, 6 pancreatic benign tumors, and 30 healthy individuals. We found that enriched cells could be classified into 5 patterns: CK+CD45-DAPI+CEP8=2 (2 hybridization signals), CK+CD45-DAPI+CEP8>2 (>2 hybridization signals), CK-CD45-DAPI+CEP8>2, CK-CD45-DAPI+CEP8=2, and CK+/-CD45+DAPI+CEP8=2 or >2. Among 22 pancreatic cancers, CK+CD45-DAPI+CEP8=2 and CK+CD45-DAPI+CEP8>2 patterns were identified in two cases, and CK-CD45- DAPI+CEP8>2 pattern was identified in 16 cases. CK-CD45-DAPI+CEP8=2 and CK+/-CD45+DAPI+CEP8=2 or >2 patterns were detected in pancreatic cancers, other pancreatic diseases and healthy individuals. Among the five patterns, CK+CD45-DAPI+CEP8=2, CK+CD45-DAPI+CEP8>2 and CK-CD45-DAPI+CEP8>2 were considered as CTCs, while CK-CD45-DAPI+CEP8=2 and CK+/-CD45+DAPI+CEP8=2 or >2 were considered as indeterminate cells. When the cutoff value was set as 2 cells/3.75 mL based on ROC curve, the sensitivity and specificity in the diagnosis of pancreatic cancer was 68.18 and 94.87%, respectively. Dynamically monitoring CTCs changes prior to and after surgery in pancreatic patients revealed that CTCs count decreased in 3 days after surgery, but increased in 10 days after surgery in most patients. During our one and a half year follow-up, CTCs positive patients showed metastasis and worse survival rate.
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Affiliation(s)
- Yujuan Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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