<p>Distribution of circulating tumor cell phenotype in early cervical cancer</p>

Abstract

Background and objective: Circulating tumor cells (CTCs) can be classified into three phenotypes based on epithelial-to-mesenchymal transition (EMT) markers, including epithelial CTCs, mesenchymal CTCs, and mixed phenotypic CTCs. This study is aimed to analyze the correlation between CTC phenotypes and the clinicopathological features of patients with early cervical cancer. Methods: Peripheral blood samples were obtained from 90 patients with early cervical cancer. CTCs were isolated and classified. The correlations of CTC counts and CTC phenotypes with clinicopathological features of patients were analyzed. Results: The positivity rate for CTCs in patients with stage I-IIA cervical cancer was 90%. An increased CTC number was observed in patients with FIGO stage II, pelvic lymph node metastasis, and lymphovascular involvement. There were 38.89% epithelial CTCs, 23.33% mesenchymal CTCs, and 14.44% mixed phenotypic CTCs, Mesenchymal CTCs were more common in patients with FIGO stage II, pelvic lymph node metastasis, lymphovascular involvement, and deep stromal invasion. Conclusion: CTCs with mesenchymal phenotypes are closely related to pelvic lymph node metastasis and lymphatic vascular invasion in stage I-IIA cervical cancer. Detection of circulating tumor cell phenotypes is helpful for the early diagnosis of cervical cancer micro-metastasis and for the assessment of disease status.

Comparison of CellSearch and Circulating Tumor Cells (CTC)-Biopsy Systems in Detecting Peripheral Blood Circulating Tumor Cells in Patients with Gastric Cancer

“…Recent studies have shown that CTCs are associated with advanced tumor stage and lymphatic vascular invasion [ 24 , 25 ]. In the present study, CTCs detected with the CellSearch system were positively correlated with the stage of disease ( P =0.022).…”

Markers of Angiogenesis, Lymphangiogenesis, and Epithelial–Mesenchymal Transition (Plasticity) in CIN and Early Invasive Carcinoma of the Cervix: Exploring Putative Molecular Mechanisms Involved in Early Tumor Invasion

“…Assessment of EpCAM and CK markers chosen to define the tumor cell enriched population revealed retention of epithelial traits in cells derived from stage IA cervical cancer, on the one hand, and redistribution of EpCAM and CK relative expression as CIN evolves to invasive carcinoma, on the other hand ( Figure 15). Interestingly, in a study by Pan et al [112] on circulating tumor cells (CTCs) from patients with cervical cancer of I-II stages, a high overall prevalence of CTCs with EpCAM(+)CK8(+) epithelial phenotype (especially in stage I) and a presence of CTCs exhibiting a mixed phenotype were described, with the incidence of the latter being increased with the stage progression and with bigger depth of stromal invasion and pelvic lymph nodes involvement, illustrating the epithelial-mesenchymal phenotypic plasticity of cervical cancer cells capable of invasion and metastasis at early clinical stages. According to our results, specific changes in the protein expression of VEGFR3/FLT4, HGFR/MET, and SLUG/SNAI2 were associated with the EMP-like phenotype of tumor cells.…”

A Review of Circulating Tumour Cell Enrichment Technologies

“…Such a downregulation of EpCAM would therefore render cells undetectable using such immunocapture methods. It has been reported that these ‘mesenchymal CTCs’ exhibit increased metastatic potential and are more aggressive metastatic precursors than their epithelial counterparts [ 63 , 64 ]. Therefore, CTC isolation based on EpCAM expression alone may give an inaccurate CTC count and also limit the heterogeneity of the CTC population for downstream analysis.…”