Abstract
BackgroundCirculating tumor cells (CTCs) have been considered great clinical significance in various cancers. However, it remains unknown that how is the role of CTCs in patients with nasopharyngeal carcinoma (NPC). We investigated the value of CTCs enumeration and karyotyping in NPC.MethodsIn the present study, we applied integrated subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) automatic testing system to detect and characterize CTCs of NPC patients. Enumeration and aneuploidy of chromosome 8 in CTCs were examined in various stages of patients with NPC. The changes of CTCs number and karyotyping post to chemotherapy were investigated in NPC.ResultsCTCs were detected by SE-iFISH in 46 out of 50 pre-treatment NPC patients, and performed a positive rate of 92.0%. No significant association was found between disease staging and CTCs detection rate. CTCs number constantly increased with TNM stage rising (from stage II to stage IV) no matter in newly diagnosed patients without distant metastasis (M0) and relapsed or distant metastatic patients. The number of CTCs decreased after treatment in patients with partial response (PR), while increased in patients with progressive disease or stable disease (PD/SD). More interestingly, CTCs karyotyping indicated that aneuploidy of chromosome 8 in CTCs was dramatically related to chemotherapeutic efficacy in NPC. Positive correlation was found between CTCs count and plasma EBV DNA level of NPC patients.ConclusionsCTCs could be detected in various stages of NPC patients using SE-iFISH. CTCs number could indicate the severity degree of disease in NPC. Dynamically monitoring the variations in CTCs number may predict chemotherapy efficacy during treatment. CTCs karyotyping is related to the sensibility of chemotherapy and drug resistance, and karyotyping of CTCs might predict therapeutic efficacy and evaluate chemo-resistance in NPC. CTCs could be used as a monitoring indicator in the fields of treatment, diagnosis and follow-up of NPC.
Highlights
Circulating tumor cells (CTCs) have been considered great clinical significance in various cancers
We applied subtraction enrichment (SE)-iFISH to detect and characterize CTCs and Circulating tumor microemboli (CTM) in patients with nasopharyngeal carcinoma (NPC), and we explored the relationship between CTCs number and clinical staging
Patient characteristics From December 2015 to June 2017, a total of 50 patients with confirmed nasopharyngeal carcinoma including twenty-nine newly diagnosed patients without distant metastasis (M0) and twenty-one relapsed or distant metastatic patients after 6 months of initial treatment were enrolled in this study
Summary
Circulating tumor cells (CTCs) have been considered great clinical significance in various cancers. It remains unknown that how is the role of CTCs in patients with nasopharyngeal carcinoma (NPC). We investigated the value of CTCs enumeration and karyotyping in NPC. Nasopharyngeal carcinoma (NPC) is a disease with low prevalence in large parts of the world, while it is notable for its high incidence in South China and South Asia. In China, there were an estimated 60,600 new cases of NPC and 34,100 deaths in 2015 [1,2,3]. NPC is an endemic carcinoma, which is different from other head and neck cancers on account of its epidemiology, histopathology, and clinical characteristics. More than 70% of newly diagnosed cases of NPC are classified as locoregionally advanced disease [4]. Previous studies have showed that concurrent chemoradiotherapy (CCRT) was more effective than
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