Circulating Tumor Cell Enumeration for Serial Monitoring of Treatment Outcomes for Locally Advanced Esophageal Squamous Cell Carcinoma.
Josephine Mun-Yee KoKa On LamDora Lai Wan KwongIan Yu-Hong WongFion Siu-Yin ChanClaudia Lai-Yin WongKwan Kit ChanTsz Ting LawKeith Wan Hang ChiuCandy Chi Shan LamJean Chrysei WongHenry Chun Hung FongFaith Sin Fai ChoyAndy LoSimon Ying-Kit LawMaria Li LungPublished in: Cancers (2023)
We aim to reveal the clinical significance and potential usefulness of dynamic monitoring of CTCs to track therapeutic responses and improve survival for advanced ESCC patients. Peripheral blood (PB) ( n = 389) and azygos vein blood (AVB) ( n = 13) samplings were recruited prospectively from 88 ESCC patients undergoing curative surgery from 2017 to 2022. Longitudinal CTC enumeration was performed with epithelial (EpCAM/pan-cytokeratins/MUC1) and mesenchymal (vimentin) markers at 12 serial timepoints at any of the pre-treatment, all of the post-treatments/pre-surgery, post-surgery follow-ups for 3-year, and relapse. Longitudinal real-time CTC analysis in PB and AVB suggests more CTCs are released early at pre-surgery and 3-month post-surgery into the circulation from the CTRT group compared to the up-front surgery group. High CTC levels at pre-treatments, 1-/3-month post-surgery, unfavorable changes of CTC levels between all post-treatment/pre-surgery and 1-month or 3-month post-surgery (Hazard Ratio (HR) = 6.662, p < 0.001), were independent prognosticators for curative treatment. The unfavorable pre-surgery CTC status was independent prognostic and predictive for neoadjuvant treatment efficacy (HR = 3.652, p = 0.035). The aggressive CTC clusters were more frequently observed in AVB compared to PB. Its role as an independent prognosticator with relapse was first reported in ESCC (HR = 2.539, p = 0.068). CTC clusters and longitudinal CTC monitoring provide useful prognostic information and potential predictive biomarkers to help guide clinicians in improving disease management.
Keyphrases
- circulating tumor cells
- minimally invasive
- coronary artery bypass
- circulating tumor
- surgical site infection
- patients undergoing
- percutaneous coronary intervention
- peripheral blood
- cross sectional
- acute coronary syndrome
- single cell
- chronic kidney disease
- gene expression
- coronary artery disease
- heavy metals
- end stage renal disease
- risk assessment
- combination therapy
- mesenchymal stem cells
- atrial fibrillation
- social media
- pulmonary embolism
- aqueous solution