Abstract
BackgroundMuch importance is attached to the clinical application value of circulating tumor cells (CTCs), meanwhile tumor-proximal CTCs detection has interested researchers for its unique advantage. This research mainly discusses the correlation of portal venous (PoV) CTCs counts in different epithelial-mesenchymal transition status with clinicopathologic parameters and postoperative prognosis in resectable pancreatic ductal adenocarcinoma patients (PDAC).MethodsPDAC patients (n=60) who received radical resection were enrolled in this research. PoV samples from all patients and peripheral venous (PV) samples from 32 patients among them were collected to verify spatial heterogeneity of CTCs distribution, and explore their correlation with clinicopathologic parameters and clinical prognosis.ResultsCTCs detectable rate and each phenotype count of PoV were higher than those of PV. Patients with recurrence had higher PV and PoV epithelial CTCs (E-CTCs) counts than recurrence-free patients (P<0.05). Some unfavourable clinicopathologic parameters were closely related to higher PoV CTCs counts. Multivariate regression analysis demonstrated that PoV mesenchymal CTC (M-CTC)s≥1/5 ml was an independent risk factor for metastasis free survival (MFS) (P=0.003) and overall survival (OS) (P=0.043).ConclusionsOur research demonstrated that portal venous was a preferable vessel for CTC test, and patients with PoV M-CTC≥1/5 ml had shorter MFS and OS time in resectable PDAC patients. PoV CTC phenotype detection has the potential to be a reliable and accurate tool to identify resectable PDAC patients with high tendency of postoperative metastasis for better stratified management.
Highlights
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive malignancies with high metastatic tendency to distant organs [1], and it has been projected to be the second most lethal tumor by 2030 [2]
peripheral PV (PV) blood samples were collected from 32 patients among them
With a median follow‐up duration of 15 months, 11 (18.3%) patients experienced local recurrence, and metastasis occurred in 30.0% (18/60), including 9 liver only metastases, 4 lung only metastases, 3 cases of multiple sites metastases, beside 3 patients had been diagnosed with both recurrence and metastatic
Summary
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive malignancies with high metastatic tendency to distant organs [1], and it has been projected to be the second most lethal tumor by 2030 [2]. Increasing evidence demonstrated that utilizing the circulating tumor cells (CTCs) count to early assess the postoperative prognosis can be considered as an efficient method in some solid tumors [5, 7,8,9]. It is worth noting that researchers have utilized tumor-proximal liquid biopsy to overcome the mentioned limitations with the enhancement of detectable rates and the enumeration of CTCs [7, 9,10,11]. We collected portal venous blood and peripheral venous blood for CTCs phenotypes detection to verify the value of tumorproximal liquid biopsy. This research mainly discusses the correlation of portal venous (PoV) CTCs counts in different epithelial-mesenchymal transition status with clinicopathologic parameters and postoperative prognosis in resectable pancreatic ductal adenocarcinoma patients (PDAC)
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