<p>Clinical Significance of Red Cell Distribution Width and Circulating Tumor Cells with an Epithelial–Mesenchymal Transition Phenotype in Lung Adenocarcinoma</p>

Abstract

To determine the prognostic value of red cell distribution width (RDW) and circulating tumor cells with epithelial-mesenchymal transition phenotype (M-CTC) in lung adenocarcinoma (LUAD). Patients and Methods: Clinical and laboratory data of 60 patients with LUAD were collected. CTCs were isolated from their peripheral blood using the CanPatrol TM CTC enrichment method. The indicators of RDW and neutrophil lymphocyte ratio (NLR) were calculated based on the laboratory standards. Results: A total of 60 LUAD patients were enrolled, of which 19 (31.7%) had high RDW (>0.14) and 32 (53.3%) were positive for M-CTCs. There was no significant correlation between RDW and the clinical characteristics. M-CTC was not significantly associated with tumor size and differentiation, age, gender, tumor stage, and histological type but correlated significantly with lymphatic metastasis (P = 0.044), high NLR (>2.26, P = 0.023), and high RDW (>0.14, P = 0.036). Furthermore, the M-CTC + LUAD patients had a significantly poor recurrence-free survival (RFS; Log rank P =0.001, HR = 2.749, 95% CI = 1.489-5.078) and overall survival (OS; Log rank P =0.022, HR = 2.283, 95% CI = 1.128-4.622) compared to the M-CTC − patients. Similarly, high RDW also correlated with worse RFS (Log rank P = 0.008, HR = 2.331, 95% CI = 1.248-4.353) and OS (Log rank P = 0.004, HR = 0.004, 95% CI = 1.398-5.525). Conclusion: M-CTC is significantly related to RDW and NLR, and an independent prognostic factor in LUAD.

Development and validation for prognostic nomogram of epithelial ovarian cancer recurrence based on circulating tumor cells and epithelial–mesenchymal transition

“…RNA-ISH was used to detect CTCs through the following target sequences: CD45 (leukocyte biomarker); vimentin and Twist (mesenchymal biomarkers); EpCAM and CK8/18/19 (epithelial biomarkers) 8 , 29 , 30 (Fig. 6 ).…”

Clinical Relevance of Mesenchymal- and Stem-Associated Phenotypes in Circulating Tumor Cells Isolated from Lung Cancer Patients

“…Many studies have shown that the EMT phenotype can be related to distinct clinical characteristics of the tumor, such as proliferation status, clinical stage, etc. In a study by Peng et al (2020) [ 53 ], CTCs from 84 patients were analyzed. The average positive rate of CTCs was 96% (median 5; range 0–68).…”

“…The average positive rate of CTCs was 96% (median 5; range 0–68). EMT + CTCs were detected in 73% of patients [ 53 ]. Increased EMT + CTCs significantly correlated with lymphatic metastasis, tumor stage, and Ki67 overexpression.…”

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

“…Although, in recent years, surgery, radiotherapy, chemotherapy and molecular targeted therapy have greatly improved the treatment of lung cancer, the 5-year overall survival rate is still low, so lung cancer is a major disease threatening people's health. [ 2 , 3 ]…”

“…Invasion and metastasis of lung cancer is the main reason that affects the quality of patients life, thus leading to poor therapeutic effect. [ 2 ] The lack of sensitive and effective methods for the detection of early invasion and metastasis of lung cancer is the main reason for the failure of detecting early lung cancer and intervention, and it is also an important factor for the increase of mortality. [ 4 ]…”