Compartmental Differences of Circulating Tumor Cells in Colorectal Cancer

Background

The prognostic role of circulating tumor cells (CTCs) has been established for colorectal cancer (CRC). We investigated the qualitative and quantitative detection of CTC in the central (CVBC) and mesenteric (MVBC) venous blood compartments to elucidate the patterns of hematogenous tumor cell dissemination in patients with CRC.

Methods

A total of 200 patients were enrolled prospectively. Blood samples were collected from the tumor-draining vein and via a central venous line. CTCs were detected and quantified by using the CellSearch system. Factors associated with CTC detection in both compartments were analyzed by using univariate and multivariate analyses.

Results

CTC analyses were performed in the CVBC and MVBC in 200 and 80 patients, respectively. CTCs were found at a higher rate (P?=?0.01) and at a higher count (P?=?0.006) in the MVBC compared with the CVBC. On multivariate analyses, stage IV disease (odds ratio, 3.83; 95% confidence interval, 1.42?C10.35) and increased preoperative carbohydrate antigen 19?C9 level (odds ratio, 3.57; 1.30?C9.79) were associated with CTC detection in the CVBC. CTCs were detected more frequently (P?=?0.05) and at higher numbers (P?=?0.05) in the CVBC of patients with low compared with mid or high rectal tumors.

Conclusions

The qualitative and quantitative detection of CTCs is higher in the MVBC compared with the CVBC of patients with CRC.     

胃、大肠癌循环癌细胞的检测

目的胃大肠癌循环癌细胞的检测。方法用常规细胞学(HE)和免疫细胞化学(ICC)方法对23例进展期胃、大肠癌切除患者门静脉系血及外周血进行癌细胞的检测。结果 23例患者中常规 HE 染色,阳性2例(8.7%),可疑3例(13%);免疫细胞化学方法,阳性4例(17.4%)。4例阳性患者血中癌细胞浓度在40-1000个/ml 范围内。结论循环癌细胞的检测可能有助于预测肝内微转移灶的发生,判断患者预后,为术后选择辅助治疗提供依据。     

Correlation of Circulating Angiogenic Factors with Circulating Tumor Cells and Disease Recurrence in Patients Undergoing Curative Resection for Colorectal Liver Metastases

Background  

Circulating angiogenic factors (CAF) have been shown as therapeutic targets and prognostic biomarkers in metastatic colorectal cancer. However, their correlation with circulating tumor cells (CTC) is unknown, as is their role as prognostic biomarkers in patients amenable for curative resection.     

Prognostic Nutritional Index Predicts Postoperative Outcome in Colorectal Cancer

Background

The prognostic nutritional index (PNI), which is calculated based on the serum albumin concentration and peripheral blood lymphocyte count, is a useful tool for predicting short-term and long-term postoperative outcome in patients undergoing cancer surgery. However, few studies have investigated PNI in colorectal cancer surgery. We examined the ability of PNI to predict short- and long-term outcomes in patients with colorectal cancer.

Methods

This retrospective study included 365 patients who underwent resection for colorectal cancer. The prognostic nutritional status was calculated on the basis of admission data as follows: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm³). The primary outcomes measured were the impact of PNI on overall survival and postoperative complications.

Results

Kaplan–Meier analysis and the log rank test revealed that low PNI was significantly associated with poor survival (P < 0.0001). In multivariate analysis for survival, preoperative low PNI was an independent prognostic factor for poor survival: odds ratio: 2.25, 95 % confidence interval 1.42–3.59). Moreover, low PNI significantly correlated with the incidence of postoperative complications, especially serious ones.

Conclusions

Preoperative PNI is a useful predictor of postoperative complications and survival in patients with colorectal cancer.     

Risk Factors for Postoperative Recurrence in Patients with Pathologically T1 Colorectal Cancer

Background  

The evolution of diagnostic procedures has resulted in an increase in early detection of pathologically T1 (pT1) colorectal cancer (CRC). However, the risk factors affecting long-term outcomes of patients with pT1 CRCs have been unclear. The aim of the present study was to identify risk factors for postoperative recurrence and overall survival in patients with pT1 CRC.     

Circulating Tumor Cells and Prognosis of Patients with Resectable Colorectal Liver Metastases or Widespread Metastatic Colorectal Cancer: A Meta-Analysis

Background

We performed a systematic review and meta-analysis to investigate the prognostic value of tumor cells in blood (circulating tumor cells [CTCs]) or bone marrow (BM) (disseminated tumor cells) of patients with resectable colorectal liver metastases or widespread metastatic colorectal cancer (CRC).

Materials and Methods

The following databases were searched in May 2011: MEDLINE, EMBASE, Science Citation Index, BIOSIS, Cochrane Library. Studies that investigated the association between tumor cells in blood or BM and long-term outcome in patients with metastatic CRC were included. We extracted hazard ratios (HRs) and confidence intervals (CIs) from the included studies and performed random-effects meta-analyses for survival outcomes.

Results

The literature search yielded 16 studies representing 1,491 patients. The results of 12 studies representing 1,329 patients were suitable for pooled analysis. The overall survival (HR, 2.47; 95 % CI 1.74–3.51) and progression-free survival (PFS) (HR, 2.07; 95 % CI 1.44–2.98) were worse in patients with CTCs. The subgroup of studies with more than 35 % CTC-positive patients was the only subgroup with a statistically significant worse PFS. All eight studies that performed multivariable analysis identified the detection of CTCs as an independent prognostic factor for survival.

Conclusion

The detection of CTCs in peripheral blood of patients with resectable colorectal liver metastases or widespread metastatic CRC is associated with disease progression and poor survival.     

Correlation Between Postoperative Early Recurrence of Hepatocellular Carcinoma and Mesenchymal Circulating Tumor Cells in Peripheral Blood

Background

Circulating tumor cells (CTCs) have been actively studied for their functions in hepatocellular carcinoma (HCC) recurrence. However, the relationship between circulating tumor cells subtypes and hepatocellular carcinoma recurrence is still unclear.

Methods

CTCs were collected from the peripheral blood of 62 postoperative HCC patients. The CTCs were isolated with a filtration-based method. Multiplex fluorescence in situ hybridization was used to characterize the CTCs based on mRNA expression levels of epithelial and mesenchymal markers.

Results

Of the 62 HCC patients, 26 were diagnosed with early recurrence (ER) and 36 did not experience recurrence. Comparison between the recurrence group and the non-recurrence group showed the total number of CTCs, mesenchymal CTCs, and mixed CTCs in the recurrence group was significantly higher than in the non-recurrence group. Receiver operator characteristic (ROC) curve analysis was performed to define the positive cutoff values as follows: total number of CTCs ≥?4, mesenchymal CTCs ≥?1, and mixed CTCs ≥?3. Analysis showed that portal vein tumor thrombus (hazard ratio [HR] = 2.905, P = 0.023) and mesenchymal CTC positivity (HR = 3.453, P = 0.007) were independent risk factors for ER. The correlation between the presence of mesenchymal CTCs and time to recurrence was further examined, and the results showed significantly shortened postoperative disease-free survival in patients positive for mesenchymal CTCs (P < 0.001).

Conclusions

HCC patients with positive peripheral mesenchymal CTCs have a more serious risk of ER, which could be a potential biomarker in HCC prognosis monitoring.

     

Neutrophil-to-Lymphocyte Ratio Predicts Recurrence Pattern in Patients with Resectable Colorectal Liver Metastases

Annals of Surgical Oncology - Studies have suggested that neutrophil-to-lymphocyte ratio (NLR) has value as a predictor of long-term outcomes in various cancer types. Its prognostic potential in...     

腹腔镜结直肠癌根治术后血清趋化因子配体5、循环肿瘤细胞CK20表达与肿瘤复发、转移的关系研究

目的:探讨腹腔镜结直肠癌根治术后血清趋化因子配体5(CXCL5)、循环肿瘤细胞CK20的表达与肿瘤复发、转移的关系。方法:选取2015年5月—2017年7月在河北中石油中心医院接受腹腔镜结直肠癌根治手术治疗的120例结直肠癌患者,术后1 d检测两组血清CXCL5、外周血循环肿瘤细胞CK20的水平,并对患者进行为期36个月的随访观察,其中发生局部复发或转移的患者84例(复发组)、未发生局部复发或转移的患者36例(对照组);比较两组患者的一般资料、病理学资料及术后1 d的CXCL5、循环肿瘤细胞CK20表达情况;采用Logistic多因素分析CXCL5、循环肿瘤细胞CK20与肿瘤复发的关系。结果:复发组和对照组的年龄、性别、体质指数(BMI)、肿瘤位置差异无统计学意义(P0.05);复发组与对照组的肿瘤直径、病理学类型、肿瘤分化程度、是否伴有肠梗阻、TNM分期、淋巴结转移、肿瘤淋巴血管侵犯比较差异有统计学意义(P0.05);复发组的血清CXCL5水平、外周血循环肿瘤细胞CK20阳性检出率高于对照组,差异有统计学意义(P0.05);Logistic多因素分析结果显示,肿瘤低分化、肠梗阻、TNM分期为Ⅲ～Ⅳ期、发生淋巴结转移、发生肿瘤淋巴血管侵犯、血清CXCL5水平增高、外周血循环肿瘤细胞CK20阳性表达是结直肠癌患者腹腔镜根治手术后复发、转移的独立危险因素(P0.05)。结论:血清CXCL5水平增高、外周血循环肿瘤细胞CK20阳性表达可增大结直肠癌患者腹腔镜根治手术后复发、转移的风险。     

Prevalence of Circulating Tumor Cells in Localized Prostate Cancer

Background

Circulating tumor cells (CTC) predict overall survival in patients with metastatic prostate cancer. The objective of this study is to measure CTC before radical prostatectomy in intermediate- and high-risk prostate cancer patients.

Materials and Methods

The study accrued 12 patients and 10 provided adequate peripheral blood sample. Blood was drawn preoperatively and assayed for CTC using the CellSearch system. Patients were categorized as CTC positive (≥ 1 CTC) or CTC negative (no CTC).

Results

Median age was 64.5 years (range 49-77 years), median prostate specific antigen was 7.4 ng/ml (range 5.7-25.7 ng/ml). Seven patients had intermediate-risk and 3 patients had high-risk prostate cancer. One patient was found to be CTC positive.

Conclusions

Our pilot study shows that CTC are rare in patients with clinically localized disease despite intermediate- to high-risk features. CTC may not be the optimal marker to predict prognosis or detect residual disease after radical prostatectomy.Key Words: Prostatic cancer, Radical prostatectomy, Circulating tumor cells