Abstract
IntroductionDesmoid tumor (DT) is a rare neoplasm with high local recurrence rates, composed of fibroblastic cells that are characterized by the expression of key molecules, including the intermediate filament vimentin, cyclooxygenase-2 (COX-2), and nuclear β-catenin, and lack of epithelial markers. Circulating tumor cells (CTCs) isolated from the peripheral blood of patients with sarcomas and other neoplasms can be used as early biomarkers of tumor invasion and dissemination. Moreover, CTCs can also re-colonize their tumors of origin through a process of “tumor self-seeding.”ObjectivesWe aimed to identify CTCs in the peripheral blood of patients with DT and evaluate their expression of β-catenin, transforming growth factor receptor I (TGF-βRI), COX-2, and vimentin proteins.Material and MethodsWe conducted a prospective study of patients with initial diagnosis or relapsed DT with measurable disease. Blood samples from each patient were processed and filtered by ISET® (Rarecells, France) for CTC isolation and quantification. The CTC expression of β-catenin, COX-2, TGF-βRI, and vimentin was analyzed by immunocytochemistry (ICC).ResultsA total of 18 patients were included, and all had detectable CTCs. We found a concordance of β-catenin expression in both CTCs and primary tumors in 42.8% (6/14) of cases by using ICC and immunohistochemistry, respectively.ConclusionsOur study identified a high prevalence of CTCs in DT patients. Concordance of β-catenin expression between primary tumor and CTCs brings new perspectives to assess the dynamics of CTCs in the blood compartment, opening new avenues for studying the biology and behavior of DT. In addition, these results open the possibility of using CTCs to predict DT dynamics at the time of disease progression and treatment. Further studies with larger sample sizes are needed to validate our findings.
Highlights
Desmoid tumor (DT) is a rare neoplasm with high local recurrence rates, composed of fibroblastic cells that are characterized by the expression of key molecules, including the intermediate filament vimentin, cyclooxygenase-2 (COX-2), and nuclear bcatenin, and lack of epithelial markers
It was shown that the limit of detection of isolation by size of epithelial tumor cells (ISET) is 1 Circulating tumor cells (CTCs)/10 ml of whole blood and that despite its high sensitivity, the distribution of CTCs in membrane spots is not uniform [30]
Two spots were tested for b-catenin and vimentin expression, two were single-stained for either COX-2 or TGFb-RI, and the last spots were stained with hematoxylin for CTC visualization
Summary
Desmoid tumor (DT) is a rare neoplasm with high local recurrence rates, composed of fibroblastic cells that are characterized by the expression of key molecules, including the intermediate filament vimentin, cyclooxygenase-2 (COX-2), and nuclear bcatenin, and lack of epithelial markers. Desmoid tumor (DT) is a rare non-metastasizing mesenchymal neoplasm that can show aggressive local behavior and thereby can impact the functionality and quality of life of the patients [1, 2]. DTs are typically diagnosed in adults (35–40 years) and are more common in women of reproductive age [3, 4]. They can affect any anatomic site but are commonly localized in the extremities, abdominal wall, and abdominal mesentery [5]. Due to the infiltrative nature of the disease, post-surgical recurrence rates can exceed 50% of cases, especially for extra-abdominal desmoids, which reinforce observation as an adequate strategy [9]
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