Clinical significance of circulating tumor cells in peripheral blood from patients with gastric cancer

Abstract

BACKGROUND The authors hypothesized that circulating tumor cells (CTCs) in patients with gastric cancer are associated with prognosis and disease recurrence. In this study, they evaluated CTCs in gastric cancer and clarified the clinical impact of CTCs. METHODS In total, 265 consecutive patients with gastric cancer were enrolled. Fourteen patients were excluded from the analysis, including 12 patients who another cancer and 2 patients who refused the treatment. The remaining 251 patients were divided into 2 groups: 148 patients who underwent gastrectomy (the resection group) and 103 patients who did not undergo gastrectomy (the nonresectable group). Peripheral blood samples were collected before gastrectomy or chemotherapy. A proprietary test for capturing, identifying, and counting CTCs in blood was used for the isolation and enumeration of CTCs. RESULTS CTCs were detected in 16 patients (10.8%) from the resection group and in 62 patients (60.2%) from the nonresectable group. The overall survival rate for the entire cohort was significantly lower in patients with CTCs than in those without CTCs (P < .0001). In the resection group, relapse‐free and overall survival in patients with CTCs was significantly lower than in patients without CTCs (P < .0001). It was noteworthy that the expression of CTCs was an independent factor for determining the overall survival of patients with gastric cancer in multivariate analysis (P = .024). In the nonresectable group, the overall survival rate was significantly lower in patients with CTCs than in those without CTCs (P = .0044). CONCLUSIONS The evaluation of CTCs in peripheral blood may be a useful tool for predicting tumor progression, prognosis, and the effect of chemotherapy in patients with gastric cancer. Cancer 2013;119:3984–3991. © 2013 American Cancer Society.

Clinical significance of circulating tumor cells in blood from patients with gastric cancer

“…reported that progression‐free survival was significantly shorter in patients with than in those without CTC ( P  = 0.016). All other studies based on the CellSearch system demonstrated that CTC had an influence on prognosis 48, 49, 51. These findings suggest that the presence or absence of CTC has an effect on the prognosis of patients with gastric cancer, even in cytometric‐based methods.…”

“…47–55 The CellSearch system was previously used to detect CTC in four (44.4%) out of nine studies using cytometric‐based assays. The findings of these CellSearch studies demonstrated that the incidence of CTC ranged between 10.8% and 18.4% and between 32.7% and 60.2% in patients with stages I–IV and stage IV, respectively 48, 49, 51, 53. These findings indicate that incidence of CTC is higher in patients with than in those without distant metastasis.…”

“…16–34,47–55 In a study on 94 patients with gastric cancer, we reported that the presence or absence of CTC evaluated by a qRT‐PCR assay for the expression of B7‐H4 correlated with the depth of tumor invasion, lymph node metastasis, stage, lymphatic invasion, and venous invasion ( P  = 0.006, P  = 0.001, P  < 0.001, P  < 0.001, and P  = 0.01, respectively) 28. In a study on 148 gastric cancer patients receiving surgical treatment, Uenosono et al 51. reported that CTC assessed by the CellSearch system correlated with the depth of tumor invasion, lymph node metastasis, distant metastasis, stage, lymphatic invasion, and venous invasion ( P  = 0.009, P  < 0.0001, P  = 0.012, P  = 0.0002, P  = 0.0003, and P  = 0.006, respectively).…”

“…In the CellSearch system, CTC are captured based on enrichment using antibody‐coated magnetic beads with epithelial‐cell adhesion molecules and discrimination using fluorescently labeled antibodies against CK and CD45. We investigated the presence or absence of CTC in peripheral blood cells from patients with gastric cancer using the CellSearch system 51. The findings obtained showed that CTC were morphologically detected using the CellSearch system, particularly in patients with unresectable advanced or recurrent gastric cancers.…”

Circulating tumor cells in gastric cancer

“…[65] 2013 93 RT-PCR STC2 The 5-year OS rate was significantly lower in patients with STC2 expressioncompared to patients without STC2 expression Uenosono et al . [66] 2013 148 CellSearch EpCAM, CK8, 18, 19…”