Clinical Potential of Circulating Tumor Cells in Colorectal Cancer: A Prospective Study

Abstract

OBJECTIVES: Circulating tumor cells (CTCs) in the blood have been used as diagnostic markers in patients with colorectal cancer (CRC). In this study, we evaluated a CTC detection system based on cell size to assess CTCs and their potential as early diagnostic and prognostic biomarkers for CRC. METHODS: From 2014 to 2015, 88 patients with newly diagnosed CRC, who were scheduled for surgery, and 31 healthy volunteers were enrolled and followed up in Pusan National University Hospital. CTCs were enriched using a centrifugal microfluidic system with a new fluid-assisted separation technique (FAST) and detected by cytomorphological evaluation using fluorescence microscopy. RESULTS: Two or more CTCs were detected using FAST in 74 patients and 3 healthy volunteers. The number of CTCs in the CRC group was significantly higher than that in the healthy volunteers ( P < 0.001). When a receiver operating characteristic curve was created to differentiate patients with CRC from healthy volunteers, the sensitivity and specificity were almost optimized when the critical CTC value was 5/7.5 mL of blood. When this value was used, the sensitivity and specificity in differentiating patients with CRC from the healthy controls were 75% and 100%, respectively. In patients with CRC with ≥5 CTCs, vascular invasion was frequently identified ( P = 0.035). All patients with stage IV were positive for CTCs. Patients with ≥5 CTCs showed a trend toward poor overall and progression-free survival. DISCUSSION: Our study demonstrated promising results with the use of FAST-based CTC detection for the early diagnosis and prognosis of CRC.

Circulating Tumor Cells Enumerated by a Centrifugal Microfluidic Device as a Predictive Marker for Monitoring Ovarian Cancer Treatment: A Pilot Study

“…This device was tested in 142 patients with seven different types of cancers, including breast, lung, and stomach cancers [30]. The sensitivity and specificity of CTCs in gastric cancer (85.3% and 90.3%, respectively, for a cut-off of two CTCs/7.5 mL in 116 patients) [31], esophageal squamous cell carcinoma (85.3% and 90.0%, respectively, for a cut-off of two CTCs/7.5 mL in 116 patients) [32], and colorectal cancer (75.0% and 100.0%, respectively, for a cut-off of five CTCs/7.5 mL in 74 patients) [33] have been demonstrated. Moreover, Baek et al found that patients with colorectal cancer with ≥5 CTCs showed a trend toward poor OS and PFS and frequent vascular invasion (p = 0.035) [33].…”

“…The sensitivity and specificity of CTCs in gastric cancer (85.3% and 90.3%, respectively, for a cut-off of two CTCs/7.5 mL in 116 patients) [31], esophageal squamous cell carcinoma (85.3% and 90.0%, respectively, for a cut-off of two CTCs/7.5 mL in 116 patients) [32], and colorectal cancer (75.0% and 100.0%, respectively, for a cut-off of five CTCs/7.5 mL in 74 patients) [33] have been demonstrated. Moreover, Baek et al found that patients with colorectal cancer with ≥5 CTCs showed a trend toward poor OS and PFS and frequent vascular invasion (p = 0.035) [33]. In addition, several studies comparing the FAST disc to other commercially available platforms, such as the immunoaffinity-based CellSearch systems [34] and the AccuCyte ® -CyteFinder ® (Rarecyte) selection-free system [35] have demonstrated the advantages of the FAST disc system, including its high-throughput, label-free isolation of CTCs and high detection rate.…”

The notch target gene HEYL modulates metastasis forming capacity of colorectal cancer patient-derived spheroid cells in vivo

“…In different human cancers, the numbers of detectable circulating tumor cells (CTCs) are associated with a worse outcome [52–54]. Interestingly, recent evidence indicates that distinct Notch pathway members are expressed in CTCs and may positively influence their metastatic potential [55–57].…”

A New Method for CTC Images Recognition Based on Machine Learning

“…The circulating tumor cells (CTCs) are the "seeds" shed from the primary tumor and/or metastatic lesions and rooted in a new "soil" transferred by the circulatory system (Paget, 1989). Circulating tumor cell is an intermediate stage of cancer metastasis, correlated with cancer aggressiveness and the likelihood of metastasis, and therefore can be used to predict disease progression and survival on a real-time basis by liquid biopsy (Lindsay et al, 2017;Praharaj et al, 2018;Anand and Roszik, 2019;Baek et al, 2019;Maly et al, 2019;Marcuello et al, 2019;Pan et al, 2019;Riebensahm et al, 2019). The molecular subtypes of CTCs, not only the CTCs count, are interrelated with the prognosis (Banys-Paluchowski et al, 2015;Cristofanilli et al, 2019;Dong et al, 2019;Stefanovic et al, 2019).…”