Abstract
To explore the clinical significance of the perioperative counts of circulating tumor cells (CTCs), mesenchymal CTCs (MCTCs), and CTC- white blood cells (WBCs) in renal cell carcinoma patients. A total of 131 patients with renal cancer who underwent operation excision from our hospital were enrolled. In addition, 20 patients with benign renal diseases were recruited as a control. Blood samples were collected from the 131 patients, before operation and 3 months after surgery. Samples were also obtained simultaneously from the control group. CanPatrol CTC detection technique was used to enrich and identify CTCs, MCTCs, and CTC-WBCs. All enrolled patients were T1-3N0M0. From these, 52 patients with renal cancer underwent radical resection, while other 79 patients underwent nephron-sparing surgery. The positive rate of CTC, MCTC, and CTC-WBC before surgery were 95.4% (125/131), 61.1% (80/131), and 11.5% (15/131), respectively. Preoperative total CTCs, MCTCs, or CTC-WBCs were poorly correlated with patients' parameters. Preoperative CTC, MCTC, or CTC-WBC showed no association with progression-free survival (PFS). In contrast, postoperative total CTCs (≥6), positive MCTCs, and positive CTC-WBCs significantly correlated with recurrence and metastasis. These results remained independent indicators for worse PFS. In addition, the increased CTC and MCTC count after surgery also correlated with unfavorable PFS. The detection of six or more total CTCs, MCTC, or CTC-WBCs in peripheral blood after surgery might help to identify a subset of patients that have higher recurrent risk than the overall population of patients with at different stages of renal cancer.
Highlights
Worldwide, renal cancer represents one of the 10 most frequently diagnosed cancers in adults, accounting for 5% in men and 3% in women of all cancer diagnoses [1]
Most patients were diagnosed as having renal clearcell carcinoma (113 cases, 86.3%), while the remaining had other types of renal cancer (18 cases, 13.7%)
We showed that total circulating tumor cells (CTCs), mesenchymal CTCs (MCTCs), and CTC-white blood cells (WBCs) play pivotal roles in cancer progression
Summary
Renal cancer represents one of the 10 most frequently diagnosed cancers in adults, accounting for 5% in men and 3% in women of all cancer diagnoses [1]. Surgical resection remains an effective therapy for clinical localized renal cancer, with options including radical nephrectomy and nephron-sparing surgery [3]. Of patients with localized renal cancer experience disease recurrence or develop metastases after surgical excision. Even in patients considered to be potentially curable by surgery, metastasis can occur in 5-10 years. A recent report revealed that circulating tumor cells (CTCs) circulate in the blood and are believed to be vital seeds for hematogeneous tumor metastasis [6]. Evidence has shown that CTC counts have clinical relevance as a surrogate biomarker to noninvasive monitor for cancer progression and therapeutic decision-making [7,8,9,10,11,12]. Increased MCTC count has been reported as a predictor of disease progression in breast cancer [14]
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