Clinical significance of circulating tumor microemboli as a prognostic marker in patients with pancreatic ductal adenocarcinoma
Journal
Clinical Chemistry
Journal Volume
62
Journal Issue
3
Pages
505-513
Date Issued
2016
Author(s)
Chen J.-Y.
Chen H.-L.
Liang T.-Y.
Wang C.-F.
Lee E.Y.H.P.
Chang Y.-C.
Lee W.-H.
Abstract
BACKGROUND: Characterization of circulating tumor cells (CTCs) has been used to provide prognostic, predictive, and pharmacodynamic information in many different cancers. However, the clinical significance of CTCs and circulating tumor microemboli (CTM) in patients with pancreatic ductal adenocarcinoma (PDAC) has yet to be determined. METHODS: In this prospective study, CTCs and CTM were enumerated in the peripheral blood of 63 patients with PDAC before treatment using anti-EpCAM (epithelial cell adhesion molecule)-conjugated supported lipid bilayer-coated microfluidic chips. Associations of CTCs and CTM with patients' clinical factors and prognosis were determined. RESULTS: CTCs were abundant [mean (SD), 70.2 (107.6)] and present in 81% (51 of 63) of patients with PDAC. CTM were present in 81% (51 of 63) of patients with mean (SD) 29.7 (1101.4). CTM was an independent prognostic factor of overall survival (OS) and progression free survival (PFS). Patients were stratified into unfavorable and favorable CTM groups on the basis of CTM more or less than 30 per 2 mL blood, respectively. Patients with baseline unfavorable CTM, compared with patients with favorable CTM, had shorter PFS (2.7 vs 12.1 months; P < 0.0001) and OS (6.4 vs 19.8 months; P < 0.0001). Differences persisted if we stratified patients into early and advanced diseases. The number of CTM before treatment was an independent predictor of PFS and OS after adjustment for clinically significant factors. CONCLUSIONS: The number of CTM, instead of CTCs, before treatment is an independent predictor of PFS and OS in patients with PDAC. ? 2016 American Association for Clinical Chemistry.
SDGs
Other Subjects
albumin; C reactive protein; CA 19-9 antigen; carcinoembryonic antigen; epithelial cell adhesion molecule; tumor marker; adult; Article; cancer chemotherapy; cancer patient; cancer prognosis; cancer survival; circulating tumor microembolus; diabetes mellitus; disease severity; female; human; leukocyte count; lipid bilayer; lymphocyte count; major clinical study; male; microembolism; microfluidics; neutrophil count; neutrophil lymphocyte ratio; overall survival; pancreas adenocarcinoma; progression free survival; prospective study; smoking; tumor differentiation; tumor embolism; tumor localization; blood; Carcinoma, Pancreatic Ductal; mortality; pathophysiology; prognosis; regression analysis; Biomarkers, Tumor; Carcinoma, Pancreatic Ductal; Female; Humans; Male; Neoplastic Cells, Circulating; Prognosis; Prospective Studies; Regression Analysis
Publisher
American Association for Clinical Chemistry Inc.
Type
journal article