Role of Circulating Tumor Cell (CTC) Monitoring in Evaluating Prognosis of Triple-Negative Breast Cancer Patients in China

Abstract

BackgroundBreast cancer (BC) is the most common malignant tumor in females. This study investigated the role and utility of CTC monitoring in evaluating the prognosis of triple-negative breast cancer patients.Material/MethodsWe enrolled 286 female triple-negative breast cancer patients who were diagnosed at and received radical resection surgery in our hospital. Peripheral venous blood samples were collected preoperatively and at 3 and 7 days postoperative, and the Cell Search system was used to detect CTC in peripheral blood. We analyzed the relationship between preoperative CTC level and clinical pathological characteristics of patients. Kaplan-Meier method was used to establish progression-free survival curves and overall survival curves, we used the log-rank test to compare the survival rate, and we explored the effects of preoperative and postoperative CTC levels on patient survival.ResultsCompared with preoperative levels, the average CTC content in peripheral blood of breast cancer patients was significantly increased at 3 days after surgery, and then decreased to the preoperative baseline level by 7 days after surgery. The 3-year overall survival rate and progression-free survival rate in patients with CTC >5/7.5 mL peripheral blood were significantly lower than in patients with CTC <5/7.5 mL peripheral blood detected preoperatively and at 3 and 7 days postoperatively.ConclusionsDynamic monitoring of preoperative and postoperative CTC levels can accurately predict recurrence and progression of disease, and is important in postoperative monitoring and prognosis evaluation.

Looking for a Better Characterization of Triple-Negative Breast Cancer by Means of Circulating Tumor Cells

“…The percentage of CTC detection described in other studies varies between 16% and 73% depending on the analytic methods used and the tumor stage [5,7]. Thus, for example, Zhang et al analyzed the levels of peri-operative CTCs using CellSearch technology in 286 cases of stages I, II and III TNBC, finding CTCs in the 23%, 37% and 56%, respectively, for each stage [7]. In a cohort of 102 patients with stage IV TNBC, Magbanua et al described a detection rate (CTCs ≥5) with the CellSearch system before starting chemotherapy of 44%, and 15 days after starting treatment this percentage dropped to the 33%.…”

“…Importantly, 42% of all analyzed patients were positive for CTCs (at least 1 CTCs) using CellSearch system, with all the positive cases being of metastatic patients. The percentage of CTC detection described in other studies varies between 16% and 73% depending on the analytic methods used and the tumor stage [5,7]. Thus, for example, Zhang et al analyzed the levels of peri-operative CTCs using CellSearch technology in 286 cases of stages I, II and III TNBC, finding CTCs in the 23%, 37% and 56%, respectively, for each stage [7].…”

“…Several studies have evidenced the presence of CTCs in TNBC patients at different stages, although the percentage is higher in metastatic patients. More importantly, CTC detection after surgery or during the adjuvant therapy administration has been associated with poor survival rates in these patients [3][4][5][6][7]. Besides, in accordance with the unfavorable prognosis of these tumors, CTC clusters are more often found in TNBC patients, indicating the existence of specially active dissemination mechanisms in these patients [8].…”

Interleukin 17A Promotes Cell Migration, Enhances anoikis resistance, and Favors Microenvironment for Triple Negative Breast Cancer Tumor Metastasis

“…Evidence suggests that poor prognosis in breast cancer might relate to CTCs [13,14], and the survival of tumor cells in circulation requires three aspects: 1.resistance to anoikis, 2. escape immune surveillance, and 3. being stable under blood shearing force. The resistance to anoikis requires several signaling pathways related to anchorage-independent growth and epithelial-mesenchymal transition, including Akt, TrkB, Src, and so on [15].…”

Polymer nanofiber-based microchips for EGFR mutation analysis of circulating tumor cells in lung adenocarcinoma

“…In recent years, numerous researches have demonstrated that CTC analysis could be used in detecting early tumor progression of various kinds of cancer, including breast, colorectal, prostate cancers and so on. [4][5][6][7] Thus, CTC analysis is now regarded as "liquid biopsy" and has been used in clinical application to predict the clinical outcomes and monitor treatment responses throughout the course of diseases. Although Cell Search™ had been allowed by the US Food and Drug Administration to detect CTCs in the clinical application in 2004, it was still constrained by its low sensitivity in epithelial cell adhesion molecule (EpCAM)-negative cases.…”