Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients.

Autor:	Kaifi JT; Division of Surgical Oncology; Hollings Cancer Center; Medical University of South Carolina; Charleston, SC USA., Kunkel M; Laboratory of Translational Oncology and Experimental Cancer Therapeutics; Division of Hematology/Oncology; Department of Medicine; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Zhu J; Department of Public Health Sciences; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Dicker DT; Laboratory of Translational Oncology and Experimental Cancer Therapeutics; Division of Hematology/Oncology; Department of Medicine; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Gusani N; Section of Surgical Oncology; Department of Surgery; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Yang Z; Department of Pathology; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Sarwani NE; Department of Radiology, Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA., Li G; Division of Surgical Oncology; Hollings Cancer Center; Medical University of South Carolina; Charleston, SC USA., Kimchi ET; Division of Surgical Oncology; Hollings Cancer Center; Medical University of South Carolina; Charleston, SC USA., Staveley-O'Carroll KF; Division of Surgical Oncology; Hollings Cancer Center; Medical University of South Carolina; Charleston, SC USA., El-Deiry WS; Laboratory of Translational Oncology and Experimental Cancer Therapeutics; Division of Hematology/Oncology; Department of Medicine; Penn State Hershey Cancer Institute; Pennsylvania State University; Hershey, PA USA.
Jazyk:	angličtina
Zdroj:	Cancer biology & therapy [Cancer Biol Ther] 2013 Dec; Vol. 14 (12), pp. 1174-81. Date of Electronic Publication: 2013 Oct 23.
DOI:	10.4161/cbt.26884
Abstrakt:	Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States when combining both genders. Circulating tumor cells (CTCs) are a prognostic marker for stage IV CRC patients. We hypothesized that CTC quantity varies among stage IV CRC populations. Methods: Blood (7.5 ml) was prospectively collected from 90 stage IV CRC patients. EpCAM(+) CTCs were analyzed with the FDA-approved CellSearch(®) system. CRC tumors were immunohistochemically stained for EpCAM expression. Imaging and clinicopathological data were collected. Statistical analysis was performed using correlation analysis, Kruskal-Wallis, Fisher exact, and log-rank test. Results: CTCs were detectable in 36/90 (40%) patients. Diffuse CRC metastases were associated with the highest CTC prevalence (24/40 [60%]), in contrast to limited lung (2/19 [11%]) or liver (10/31 [32%]) metastases (P = 0.027). The overall mean CTC number was 2.0 (range 0-56.3). The mean CTC number in patients with diffuse metastases was significantly higher (3.7 [SEM ± 1.7, range 0-56.3]) than with limited lung metastases (0.1 [± 0.1; range 0-1]) or liver metastases (0.9 [± 0.3, range 0-7.0]) (P = 0.001). CRC tumors were consistently expressing EpCAM. CTC numbers did not correlate with serum CEA levels or other routine clinical parameters (P = N.S.). Patients with diffuse metastases had the poorest overall survival (P = 0.0042). Conclusions: CRC patients with diffuse metastases have the highest number of CTCs, in contrast to limited metastases to the liver or lungs. Future studies should correlate CTCs with recurrence patterns in patients with resected CRC lung or liver metastases to investigate whether CTCs represent micrometastatic disease causing early relapses.
Databáze:	MEDLINE
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