Research on relationship between the circulating tumor cells and esophageal squamous cell carcinoma clinicopathological characteristics

Abstract

Objective To evaluate the diagnostic value of circulating tumor cells (CTCs) with expressing epithelial-mesenchymal transitions (EMT) biomarkers in esophageal squamous cell carcinoma (ESCC) patients and investigated the association with their clinicopathological parameters. Methods We included 174 patients with ESCC as the observation group and 40 healthy volunteers as negative control group. According to the different treatment stages, blood samples from ESCC patients were analyzed qualitatively and quantitatively for CTCs in peripheral blood. Results (1) The total CTCs in 174 ESCC patients was higher than that in 40 healthy volunteers (21 vs. 0), and the positive rate was also higher than that of healthy volunteers (99.4% vs. 35.0%), the area under receiver operating characteristic curve (ROC) of epithelial CTCs, mesenchymal CTCs and total CTCs were 0.813, 0.782 and 0.991, respectively. The clinical diagnostic critical point of each phenotypes of CTCs were 2, 0 and 3, respectively; (2) For ESCC patients, the more the mesenchymal CTCs, the later the clinical stage; (3) Follow-up blood specimens were obtained from neoadjuvant chemotherapy in ESCC patients. Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) after treatment were seen in 2, 20, 13 and 4 patients, respectively. Patients with a negative mesenchymal CTCs status after two cycles of chemotherapy had a good chemosensitivity (P<0.05), and the positive rate of mesenchymal CTCs in SD/PD (70.6%) was significantly higher than that in CR/PR (36.4%) group; (4) We compare the changes in CTCs between preoperative and postoperative of 47 ESCC patients, and the analysis revealed that the total CTCs of postoperative patients were decreasing (P<0.01), however, mesenchymal CTCs were increasing dramatically (P<0.01). Conclusion Mesenchymal CTCs as a biochemical marker of ESCC has a certain value in diagnosis of ESCC, which is significantly correlated with the clinical stage and chemosensitivity of the tumor. Key words: Esophageal cancer; Circulating tumor cells; Epithelial-mesenchymal transition; Vimentin