Circulating tumor cells undergoing EMT are poorly correlated with clinical stages or predictive of recurrence in hepatocellular carcinoma

Abstract

Experimental and clinical studies have highlighted that circulating tumor cell (CTC) with phenotypic hallmarks of epithelial-mesenchymal transition (EMT) plays a critical role in the metastatic and recurrence of solid malignancy. Here we retrospectively evaluated the presence of CTC and its EMT phenotypes in hepatocellular carcinoma (HCC) patients and investigated their clinical relevance. We optimized the Canpatrol TM CTC analysis system to enumerate CTC and classify EMT phenotypes in 113 HCC patients before curative treatment and 143 HCC patients after curative treatment. The relationships between CTC and clinical characteristics were statistically analyzed. None of total CTC or its EMT phenotypes in HCC patients was correlated with clinical characteristics, such as age, sex, HBsAg, Child-Pugh score, liver cirrhosis, AFP, number of tumors, tumor size, vascular invasion and BCLC stage. Neither the level of total CTC nor its EMT phenotypes in HCC patients before or after curative treatment were predictive of recurrence. Additionally, dynamic changes of CTC and its EMT phenotypes were not relevant to HCC recurrence after curative treatment in our study. Wefound CTC count and EMT classification were not correlated with clinical stages or predictive of HCC recurrence, but further large, multicenter studies are needed to confirm these results.

Sequential Circulating Tumor Cell Counts in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma: Monitoring the Treatment Response

“…Although serial monitoring of cell-free DNA was common, almost all reported CTC studies did only one to two measurements of CTC. For example, CTC counts have been used in previous studies for determining the diagnosis and assessing the prognosis of patients with HCC [15][16][17][30][31][32]. A correlation exists between the postoperative early recurrence of HCC and mesenchymal CTCs [32,33].…”

“…For example, CTC counts have been used in previous studies for determining the diagnosis and assessing the prognosis of patients with HCC [15][16][17][30][31][32]. A correlation exists between the postoperative early recurrence of HCC and mesenchymal CTCs [32,33]. An elevated number of CTCs is associated with unfavorable clinicopathologic characteristics responsible for poor prognosis in patients with HCC [34].…”

Single chromosome gains can function as metastasis suppressors and metastasis promoters in colon cancer

“…Aneuploidy-induced cell state transitions may be a novel cause of the strong correlation between aneuploidy and death from cancer. Additionally, recent evidence has underscored the importance of phenotypic plasticity in the metastatic cascade and has suggested that an EMT is neither a necessary nor an irreversible step in cancer cell dissemination (Chen et al 2019;Padmanaban et al 2019;Zheng et al 2015;Fischer et al 2015;Liu et al 2019). Instead, cancer cells can lose certain epithelial characteristics to promote migration out of the primary tumor site and into circulation, but they can re-establish them (through a mesenchymal-epithelial transition) in order to colonize a distant location (Dongre and Weinberg 2019).…”

Effect of phenotypic detection of circulating tumor cells marked by epithelial-mesenchymal transformation on the prognosis of lung cancer

“…EMT is considered as one of the key mechanisms of invasion and metastasis of lung cancer. [ 6 ] Therefore, the detection and analysis of interstitial CTCs in lung cancer is of great value clinically.…”