Practical value of identifying circulating tumor cells to evaluate esophageal squamous cell carcinoma staging and treatment efficacy

Abstract

BackgroundThis study was conducted to investigate the correlation between clinicopathological features and post‐therapeutic response in esophageal squamous cell carcinoma (ESCC) patients. Peripheral blood circulating tumor cells (CTCs) expressing epithelial‐mesenchymal transition markers were identified.MethodsPeripheral blood samples were collected from 71 patients with newly diagnosed ESCC and 40 healthy volunteers. CTCs were isolated using CanPatrol CTC enrichment technology. RNA‐fluorescent in situ hybridization was used to phenotype the CTCs on the basis of epithelial and/or mesenchymal markers.ResultsThe median mesenchymal CTC counts in 71 patients were: 0 in 19 stage I patients, 2 in 31 stage II, and 3 in 21 stage III/IV. The overall diagnostic performance of total CTCs to correctly identify ESCC patients was 0.991. We observed a correlation between increases in tumor size or advanced stage and an increased number of mesenchymal CTCs (P < 0.05). Thirty‐nine patients were administered two cycles of neoadjuvant chemotherapy and their therapeutic response was evaluated: 2 complete response, 20 partial response, 13 stable disease, and 4 progressive disease. After treatment, the positive rate of mesenchymal CTCs was 70.6% in the progressive and stable disease group versus 36.4% in the complete and partial response group (P = 0.05).ConclusionThe results showed that mesenchymal CTC count is related to ESCC clinical stage and the efficacy of neoadjuvant chemotherapy.

Clinical significance of detecting circulating tumor cells in patients with esophageal squamous cell carcinoma by EpCAM‑independent enrichment and immunostaining‑fluorescence in�situ hybridization

“…CTCs are derived from primary or metastatic lesions, and metastasis begins with epithelial-mesenchymal transition (EMT). Chen et al (41) and Han et al (42) demonstrated the importance of the EMT process in tumor metastasis and CTC production; however, CTC clusters, also known as microemboli, were not detected in any of the cohorts enrolled in these studies (41,42). Clustered cancer cells in the blood have been reported to serve as an indicator of poor prognosis and early recurrence in lung cancer (43,44), and high malignancy in breast cancer (30,45); however, to the best of our knowledge, they have not been studied in ESCC.…”

Fugitives on the run: circulating tumor cells (CTCs) in metastatic diseases

“…One such study assessing the clinical relevance of epithelial, mesenchymal and epithelial-mesenchymal CTCs in colorectal cancer found that only mesenchymal and epithelial-mesenchymal CTCs, not epithelial CTCs, correlated with clinical stage and metastasis [13]. Similarly, mesenchymal CTCs in esophageal squamous cell carcinoma have been shown to denote clinical stage and treatment efficacy [14]. These findings support the importance of isolating mesenchymal CTCs for inclusion in downstream analysis.…”

The Diagnostic and Prognostic Value of a Liquid Biopsy for Esophageal Cancer: A Systematic Review and Meta-Analysis

“…A total of ten studies were enrolled for the PFS analysis of 822 EC patients [ 13 , 25 , 26 , 27 , 29 , 54 , 75 , 84 , 86 , 87 ]. In this cohort, the average age was 63.3 years (61.5–66) and the median CTC positivity rate was 46.2% (18.0–79.7).…”