Distribution and Clinical Analysis of EpCAM+/Vimentin+ Circulating Tumor Cells in High-Risk Population and Cancer Patients.

Chunjin Huang,Chunyan Huang,Ping Song,Xiaodong Liu,Feng Pan,Jian Zhou,Xiaofei Liang,Haijiao Zhang,Sheng Ding,Xinyan Wang

doi:10.3389/fonc.2021.642971

Abstract

Circulating Tumor Cells (CTCs) are already present in the peripheral blood of patients with early tumors and even precancerous lesions. The objective of this study was to determine the count of CTCs in peripheral blood from high-risk population(HRP), healthy subjects and patients with Pan-cancer. The CTCs in the peripheral blood from HRP and cancer patients were enriched and identified based on the positive sorting method by epithelial cell adhesion molecular (EpCAM) liposome magnetic bead (Ep-LMB) and Vimentin liposome magnetic bead (Vi-LMB). Simultaneously, further analysis was carried out focusing on the clinical characteristics of patients by collecting the peripheral blood samples from healthy subjects as the parallel control. According to the results, the prepared LMBs had high specificity and stability, resulting in an average (Av) proliferation rate of over 90% for each cell line, and the average capture rate of higher than 80%. In terms of CTCs count detection in clinical blood samples, the average count was 0.9 (Ep: Av=0.6, Vi: Av=0.3), 2.4 (Ep: Av=1.4, Vi: Av=0.8) and 7.3 (Ep: Av=4.0, Vi: Av=3.3) in healthy subjects, HRP and total cancer patients, respectively. Besides, there was no obvious difference in the average count of CTCs among patients with different cancer types. While count of CTCs in the aforementioned cancer patients was statistically different from that in healthy subjects and patients with HRP. The survival time of cancer patients whose number of CTCs is greater than the average is significantly increased. Collectively, the study confirmed that CTCs can achieve early tumor detection and auxiliary diagnosis, and its number is related to the occurrence and development of tumors, and CTCs can be detected in HRP and sub-health population.

Highlights

Circulating tumor cells (CTCs) are cells originating from the primary lesion that abscission to the peripheral blood; they have a putative role in metastasis formation [1, 2]
CTCs has been found in prostate cancer, colorectal cancer, breast cancer, lung cancer, ovarian cancer, liver cancer, bladder cancer and other solid tumors, which is becoming an independent predictor of tumor prognosis and response to treatment [26, 27]
For colorectal cancer patients receiving first-line treatment, the change of CTCs count before and after treatment can be regarded as a predictor of progression-free survival (PFS) and overall survival (OS) [28]

Summary

Introduction

Circulating tumor cells (CTCs) are cells originating from the primary lesion that abscission to the peripheral blood; they have a putative role in metastasis formation [1, 2]. Their presence in patients with solid tumors at all disease stages is well established [3, 4], and they have the same cytomorphologic features as the solid tumor [5]. The recent methods of epithelial cell adhesion molecule (EpCAM)-based CTCs analysis showed limitations to detect CTCs in patients with tumors [13, 14], because some CTCs express only epithelial or mesenchyme markers [15, 16]. A novel EpCAM+/Vimentin+ -based CTCs analysis method had been developed on the basis of this fact

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Conclusion