Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients

Wang, Lili; Zhou, Shichao; Zhang, Wenying; Wang, Jiong-Yi; Wang, Meiling; Hu, Xiaohua; Liu, Feng; Zhang, Yanjie; Jiang, Bin; Han, Yuanfei

doi:10.1007/s00384-018-03223-9

Cited by 32 publications

(34 citation statements)

References 35 publications

(37 reference statements)

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“…In patients with small cell lung cancer, higher numbers of CTC were observed in patients with lymph node metastasis (N1-3) and III/IV stage of TNM (31). Similar results have been found in patients with colorectal and gastric cancer (28,32,33). A meta-analysis of 18 articles on CTCs in esophageal carcinoma has also shown a significant association with TNM staging (34).…”

Section: Discussionsupporting

confidence: 71%

Cytopathological Heterogeneity of Circulating Tumor Cells in Non-metastatic Esophageal Adenocarcinoma

et al. 2020

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Background/Aim: The presence of circulating tumor cells (CTC) has been reported to have an impact on prognosis in different tumor entities. Little is known about CTC morphology and heterogeneity. Patients and Methods: In a multicenter setting, pre-therapeutic peripheral blood specimens were drawn from patients with non-metastatic esophageal adenocarcinoma (EAC). CTCs were captured by size-based filtration (ScreenCell ®), subsequently Giemsa-stained and evaluated by two trained readers. The isolated cells were categorized in groups based on morphologic criteria. Results: Small and large single CTCs, as well as CTC-clusters, were observed in 69.2% (n=81) of the 117 specimens; small CTCs were observed most frequently (59%; n=69), followed by large CTCs (40%; n=47) and circulating cancer-associated macrophage-like cells (CAMLs; 34.2%, n=40). Clusters were rather rare (12%; n=14). CTC/CAML were heterogeneous in the cohort, but also within one specimen. Neither the presence of the CTC subtypes/CAMLs nor the exact cell count were associated with the primary clinical TNM stage. Conclusion: Morphologically heterogenic CTCs and CAMLs are present in patients with non-metastatic, non-pretreated EAC. Over the past decades the incidence of esophageal squamous cell carcinoma has decreased significantly in the U.S. and Europe. At the same time, the incidence of adenocarcinoma (EAC) has increased rapidly, especially among men (1). Although overall survival has improved over the years thanks to new treatment strategies, the prognosis is still limited (2). We still lack tools for better pre-therapeutic risk-stratification for cancer recurrence, which would enable us to design patientadapted treatment strategies. Currently, treatment decisions are being made based on CT-scans, endoscopic findings, endoscopic ultrasound and tumor biopsy. This momentary pretherapeutic "tumor-image" of the patient does not adequately reflect the actual tumor biology and aggressiveness. More than 50% of the patients initially considered curable will eventually relapse or develop metastasis after complete resection of the tumor (3). This relapse could be due to clinically invisible distant micro-metastases and tumor dissemination at an early time point, or due to lack of treatment response. A promising tool to evaluate these occult metastases for risk stratification and treatment surveillance is the use of liquid biopsy (4). Liquid biopsy summarizes the analysis of tumor cells and tumor-derived products in body fluids, like circulating tumor cells (CTC) (5-7), circulating tumor DNA (ctDNA) (8, 9) and extracellular vesicles (EVs) (10-12). In the case of EAC, there are very limited studies available regarding CTC presence and their significance in general (5, 13-16). CTC have been found in about 20% of patients using epithelial surface antigen (EpCAM)-dependent isolation devices in EAC. These patients 5679 This article is freely accessible online.

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Section: Discussionsupporting

confidence: 71%

Cytopathological Heterogeneity of Circulating Tumor Cells in Non-metastatic Esophageal Adenocarcinoma

et al. 2020

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“…Current research has confirmed that CTCs detected in blood can be used as an independent prognostic factor for tumors such as prostate cancer [81], breast cancer [82], and colon cancer [83,84]. The higher the number of CTCs detected, the worse the prognosis of patients.…”

Section: Ctcs and Ctdna As Prognostic Markers In Crcmentioning

confidence: 90%

“…There are few studies on CTC detection for the screening of CRC. In a recent prospective study, CTCs were tested and [76,85,87] EpCAM CellSearch™ Prognostic [83] CD45 Cyttel Predictive and prognostic [89] CK-19, EpCAM CK19-Epispot and CellSearch™ Prognostic [103] EpCAM, APC, KRAS, PIK3CA NGS, CGH, CellSearch™ Therapy and relapse monitoring [105] KRAS PNA-based qPCR Therapy monitoring [114] LGR5, EMT CanPatrol™, mRNA ISH Prognostic [115] CK20 CMx platform Monitoring early recurrence [116,117] EpCAM CellSearch™ Predictive and prognostic BioMed Research International counted in 620 patients (including healthy individuals, stage I-IV CRC patients, and precancerous lesions), and the data showed that the overall accuracy of CTC detection for all colorectal disease stages, including precancerous lesions, was 88% [65]. In addition, the isolation and count of circulating endothelial cell clusters derived from tumors in CRC may provide a new perspective for distinguishing patients with early-stage colon cancer from healthy individuals [66].…”

Section: Clinical Application Of Ctcs and Ctdna In Crcmentioning

confidence: 99%

Perspectives of the Application of Liquid Biopsy in Colorectal Cancer

Ding

Wang

et al. 2020

BioMed Research International

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Colorectal cancer (CRC) is one of the most common gastrointestinal tumors and the second leading cause of cancer death worldwide. Since traditional biopsies are invasive and do not reflect tumor heterogeneity or monitor the dynamic progression of tumors, there is an urgent need for new noninvasive methods that can supplement and improve the current management strategies of CRC. Blood-based liquid biopsies are a promising noninvasive biomarker that can detect disease early, assist in staging, monitor treatment responses, and predict relapse and metastasis. Over time, an increasing number of experiments have indicated the clinical utility of liquid biopsies in CRC. In this review, we mainly focus on the development of circulating tumor cells and circulating tumor DNA as key components of liquid biopsies in CRC and introduce the potential of exosomal microRNAs as emerging liquid biopsy markers in clinical application for CRC.

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“…In CRC, the novel BCAT1/IKZF1 blood test was found to be more sensitive for recurrence compared to carcinoembryonic antigen (CEA) as a marker, and the likelihood of recurrence given a positive BCAT1/IKZF1 result was twice that compared to a positive CEA result [32] . [87] , 2019 ctDNA 11/0 EC P, T, NT Mutation WES and NGS panel…”

Section: Detection Of Minimal Residual Diseasementioning

confidence: 99%

Precision medicine for gastrointestinal cancer: Recent progress and future perspective

Matsuoka

Yashiro

2019

WJGO

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Gastrointestinal (GI) cancer has a high tumor incidence and mortality rate worldwide. Despite significant improvements in radiotherapy, chemotherapy, and targeted therapy for GI cancer over the last decade, GI cancer is characterized by high recurrence rates and a dismal prognosis. There is an urgent need for new diagnostic and therapeutic approaches. Recent technological advances and the accumulation of clinical data are moving toward the use of precision medicine in GI cancer. Here we review the application and status of precision medicine in GI cancer. Analyses of liquid biopsy specimens provide comprehensive real-time data of the tumor-associated changes in an individual GI cancer patient with malignancy. With the introduction of gene panels including next-generation sequencing, it has become possible to identify a variety of mutations and genetic biomarkers in GI cancer. Although the genomic aberration of GI cancer is apparently less actionable compared to other solid tumors, novel informative analyses derived from comprehensive gene profiling may lead to the discovery of precise molecular targeted drugs. These progressions will make it feasible to incorporate clinical, genome-based, and phenotype-based diagnostic and therapeutic approaches and apply them to individual GI cancer patients for precision medicine.

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Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients

Cited by 32 publications

References 35 publications

Cytopathological Heterogeneity of Circulating Tumor Cells in Non-metastatic Esophageal Adenocarcinoma

Cytopathological Heterogeneity of Circulating Tumor Cells in Non-metastatic Esophageal Adenocarcinoma

Perspectives of the Application of Liquid Biopsy in Colorectal Cancer

Precision medicine for gastrointestinal cancer: Recent progress and future perspective

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