The prognostic value of circulating tumour cells (CTCs) and CTC white blood cell clusters in patients with renal cell carcinoma

Guan, Yawen; Xu, Fangshi; Tian, Jie; Gao, Ke; Wan, Ziyan; Wang, Yiyuan; Gao, Mei; Wang, Zhenlong; Chong, Tie

doi:10.1186/s12885-021-08463-7

Cited by 25 publications

(26 citation statements)

References 28 publications

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“…These results could help clinicians assess patient outcomes and develop treatment strategies. Similar findings have been demonstrated for advanced renal cell carcinoma (27,28), liver cancer (29), breast cancer, and gastric cancer (30,31). In addition, according to the combined analysis, patients with ≥7 CTCs and with CTC-WBC clusters had the highest risk of progression.…”

Section: Discussionsupporting

confidence: 80%

“…At present, no general understanding exists regarding the frequency of CTC-WBC clusters in various cancer types. Previous studies have reported the frequency of patients positive for CTC-WBC clusters to be in the range of 3.4-41.6% (27,29,30). Meanwhile, in the present study, the frequency of these patients was 29.27%, which might be related to the tumor types and enrichment methods.…”

Section: Discussioncontrasting

confidence: 43%

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Analysis of the prognostic role and biological characteristics of circulating tumor cell-associated white blood cell clusters in non-small cell lung cancer

Li¹,

Fan²,

Wu³

et al. 2022

J Thorac Dis

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Background: Recently, circulating tumor-cell-associated white blood cell (CTC-WBC) clusters have been reported to have prognostic value in some cancers. The prognostic role of CTC-WBC clusters in lung cancer has not yet been elucidated. Very little information is available about the biological characteristics of CTC-WBC clusters.Methods: A total of 82 patients with non-small cell lung cancer (NSCLC) were included in this study, and 61 patients with advanced-stage disease were closely followed-up. All patients had blood drawn prior to treatment. Subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) platform was used to isolate and identify CTCs and CTC-WBC clusters. Kaplan-Meier survival analysis and Cox regression analysis were applied to assess patient progression-free survival (PFS). Further, qualitative and quantitative analyses the size and ploidy characteristics of CTC-WBC clusters.Results: Firstly, CTC-WBC clusters appeared more in the advanced (stage III and IV) stage (P=0.043) than in the early stage. Furthermore, the multivariable analysis (Cox proportional hazards model) revealed that the high-CTC (≥7/6 mL) group and CTC-WBC clusters (≥1/6 mL) positive group both had significantly worse PFS, with a hazard ratio (HR) of 2.89 [95% confidence interval (CI): 1.36-6.17, P=0.006] and 2.18 (95% CI: 1.07-4.43, P=0.031), respectively. In the conjoint analysis, compared to patients with <7 CTCs/6 mL without CTC-WBC clusters, patients with ≥7 CTCs/6 mL with CTC-WBC clusters had the highest risk of progression (HR =7.13, 95% CI: 2.51-20.23, P<0.001). In addition, the presence of ≥3-cell CTC-WBC clusters in patients may indicate a shorter PFS (P<0.05) and a higher risk of progression (HR =2.90, 95% CI: 1.06-7.89, P=0.037). Furthermore, compared with the characteristics of the total CTCs, almost all of the CTCs that could recruit WBCs were large cells (≥5 μm) and exhibited polyploidy (≥ tetraploid) (both P<0.01). Conclusions:The presence of CTC-WBC clusters was an independent prognostic factor for advanced NSCLC. The joint analysis of CTCs and CTC-WBC clusters could provide additional prognostic value to the enumeration of CTCs alone. Besides, most of the CTCs in CTC-WBC clusters were large polyploid cells.Keywords: Circulating tumor cell (CTC); circulating tumor-cell-associated white blood cell cluster (CTC-WBC cluster); non-small cell lung cancer (NSCLC); progression-free survival (PFS)

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 43%

Analysis of the prognostic role and biological characteristics of circulating tumor cell-associated white blood cell clusters in non-small cell lung cancer

Li¹,

Fan²,

Wu³

et al. 2022

J Thorac Dis

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“…The CanPatrol CTC analysis system used in this study is a novel method that enables the detection of CTC-WBC clusters as well as total CTCs and EMT phenotypes of CTCs ( 18 , 22 ). Using the membrane filtration method that does not rely on surface markers, this system can enrich a variety of CTC subtypes and the CTC-WBC cluster, followed by EMT typing of the enriched CTCs and the CTC-WBC cluster through the fluorescence-labeled epithelial or mesenchymal markers.…”

Section: Discussionmentioning

confidence: 99%

Circulating tumor cell associated white blood cell cluster as a biomarker for metastasis and recurrence in hepatocellular carcinoma

Chen

Luo

et al. 2022

Front. Oncol.

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BackgroundRecently, an in vivo study demonstrated that circulating tumor cell-associated white blood cell (CTC-WBC) cluster possess much greater potential than single CTCs. We aim to explore the correlation between the CTC-WBC cluster and the clinicopathological characteristics of hepatocellular carcinoma (HCC) patients to seek novel biomarkers for HCC metastasis and recurrence.MethodsWe retrospectively analyzed 136 HCC patients from October 2014 to March 2020 who received CTC tests using the CanPatrol CTC enrichment technique. The correlation between the clinical features and total CTCs, EMT-CTCs, and CTC-WBC cluster were analyzed by a chi-square test. The ROC curves were simulated for evaluating the diagnostic performance of CTC parameters in HCC metastasis. Patients were followed up from February 2015 to November 2021, and the relapse-free survival (RFS) was analyzed using the Kaplan–Meier curve.ResultsA total of 93.4% (127/136) and 31.6% (43/136) of HCC patients had detectable CTCs and CTC-WBC clusters. Baseline CTC-WBC cluster was closely correlated with microvascular invasion, portal vein tumor thrombus, and extrahepatic metastasis in pre-treatment HCC patients (P <0.05). The simulated ROC curves presented an AUC of 0.821 for the CTC-WBC cluster (sensitivity of 90.0% and specificity of 93.7%) in discriminating metastasis from non-metastatic HCC, which was higher than that for total CTCs (0.718) and EMT-CTCs (0.716). Further follow-up analysis showed that compared to the CTC-WBC cluster negative group (<1/5 ml), patients in the CTC-WBC cluster positive group (≥1/5 ml) presented an increased relapse ratio (60.0% versus 17.9%) and shorter RFS (22.9 versus 53.8 months). Dynamic analysis of CTCs parameters showed that total CTC level, EMT-CTCs proportion, and CTC-WBC cluster were decreased after microwave ablation treatment, while CTC-WBC cluster increased on average 10 months in advance of imaging (MRI) diagnosed recurrence.ConclusionThe CTC-WBC cluster is a promising biomarker for the metastasis diagnosis and prognosis of HCC metastasis. Dynamic monitoring of the CTC-WBC cluster is an effective method for early detection and intervention of HCC recurrence and metastasis.

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“…Szczerba et al [ 15 ] has revealed the role of neutrophils as escorts in the blood steam to promote the cell cycle progression and accelerate metastasis formation in the breast cancer model. Researches seeking the crosstalk between the tumor prognosis and CTC-WBC clusters have been conducted in several cancers, including those of breast [ 15 ], lung [ 16 ], renal [ 17 ], liver [ 18 ] and gastric [ 19 ], but absent for CRC.…”

Section: Introductionmentioning

confidence: 99%

Association of circulating tumor cell-white blood cell clusters with survival outcomes in patients with colorectal cancer after curative intent surgery

Zhang

et al. 2022

BMC Gastroenterol

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Background The analysis of circulating tumor cell-associated white blood cell (CTC-WBC) clusters represented the progress in the liquid biopsy of malignant tumors, however, related research in patients with colorectal cancer is still absent. Methods To explore associations between CTC-WBC clusters and the prognosis of these patients, we conducted an independent cohort of 329 colorectal cancer patients after curative intent surgery and pre-operative CTC detection in Nanfang Hospital, Southern Medical University, Guangzhou, China between January 1, 2017, and September 31, 2019. The primary cohort referred to patients with CTC-WBC clusters positive. The control cohort was defined as those with exclusively CTCs positive. CTCs were enriched and distinguished by The CanPatrol™ system (SurExam, China). The Kaplan–Meier curve was used to compare the progressive-free survival (PFS) and overall survival (OS) between two groups. The COX regression model was used to assess the predictive value of CTC-WBC clusters. Results Sixty three patients presented CTC-WBC clusters positive (CTC-WBC group) and 266 patients showed solely CTCs (CTC group). The number of CTCs was significantly different between two groups (P < 0.001) and the rest of clinical characteristics were not markedly associated with the presence of CTC-WBC clusters. Kaplan–Meier curves of PFS and OS exhibited that the CTC-WBC group had significantly shorter PFS (P = 0.011), while not for OS. The multivariate model further suggested that the CTC-WBC clusters (Hazard Ratio = 1.89, 95% Confidence Interval 1.02–3.51, P = 0.042) was an independent predictor for the PFS of in post-operation CRC patients. Conclusion The CTC-WBC cluster is significantly associated with recurrence after operation in CRC patients. This finding facilitates the evaluation of this indicator in tumor progression.

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The prognostic value of circulating tumour cells (CTCs) and CTC white blood cell clusters in patients with renal cell carcinoma

Cited by 25 publications

References 28 publications

Analysis of the prognostic role and biological characteristics of circulating tumor cell-associated white blood cell clusters in non-small cell lung cancer

Analysis of the prognostic role and biological characteristics of circulating tumor cell-associated white blood cell clusters in non-small cell lung cancer

Circulating tumor cell associated white blood cell cluster as a biomarker for metastasis and recurrence in hepatocellular carcinoma

Association of circulating tumor cell-white blood cell clusters with survival outcomes in patients with colorectal cancer after curative intent surgery

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