Abstract
In the previous study, we had showed the expression of CD133+ CD54+ CD44+ cellular subpopulation of circulating tumor cells (CTCs) was significantly associated with liver metastasis of colorectal cancer (CRC). This study aimed to explore whether this subpopulation of CTCs have a prognostic value in CRC patients. Flow cytometry was used to detect the expression of cellular subpopulations of CTCs with CD133, CD54, and CD44 in 152 CRC patients, between December 2013 and October 2014. The impact of clinicopathological factors and the expression of cellular subpopulations of CTCs on overall survival were then analyzed. CRC patients with liver metastases who underwent resection of the primary tumor accompanied by surgical treatment for metastasis had a better survival than other patients (P < 0.001). The liver metastatic CRC patients with high expression of CD133+ CD54+ (P < 0.001), CD133− CD54+ (P = 0.004), and CD133+ CD44+ CD54+ (P = 0.003) cellular subpopulations of CTCs had a worse survival than those patients with low expression. Multivariable survival analyses identified carcinoembryonic antigen levels (hazard ratio [HR] = 3.056; 95% confidence interval [CI] = 1.354–6.897; P = 0.007), treatment strategy (HR = 0.212; 95% CI = 0.056–0.808; P = 0.023), and CD133+ CD44+ CD54+ cellular subpopulation of CTCs (HR = 6.459; 95% CI = 1.461–28.558; P = 0.014) as independent prognostic factors for CRC patients with liver metastasis. CD133+ CD44+ CD54+ cellular subpopulation of CTCs has a prognostic value in CRC patients with liver metastasis, especially in the survival of CRC patients with liver metastasis who did not undergo surgical treatment for metastasis.
Highlights
Owing to the identification of risk factors, introduction and dissemination of screening tests and improvements in treatment, mortality rate of colorectal cancer (CRC) have been declining in recent years; the existence of liver metastasis is still one of the most important prognostic factors for CRC patients [1,2,3]
We reported that the expression of CD133+CD54+CD44+ cellular subpopulation of Circulating tumor cells (CTCs) was significantly associated with liver metastasis in CRC patients [19]
Liver metastasis is one of the most important prognostic factors for CRC, and increasing evidence indicates that synchronous metastatic colorectal liver disease is associated with a disseminated disease state and a worse prognosis [5, 20]
Summary
Owing to the identification of risk factors, introduction and dissemination of screening tests and improvements in treatment, mortality rate of colorectal cancer (CRC) have been declining in recent years; the existence of liver metastasis is still one of the most important prognostic factors for CRC patients [1,2,3]. The evaluation and identification of new prognostic factors for synchronous liver metastasis provide the chance to explore new effective treatment. Prognostic Value of CD133+CD54+CD44+ CTCs strategies and to improve the survival of CRC patients with liver metastasis [6, 7, 9]. MICs are critical to understand the biological mechanism of metastasis and are an important factor in identifying new treatments to increase the survival of metastatic CRC patients [11,12,13]. We reported that the expression of CD133+CD54+CD44+ cellular subpopulation of CTCs was significantly associated with liver metastasis in CRC patients [19]. We aimed to explore whether this cellular subpopulation in the peripheral blood has a prognostic value for CRC patients, especially those with liver metastasis
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