The role of folate receptor-positive circulating tumor cells in the prognosis analysis of esophageal squamous cell carcinomas.

Abstract

e15026 Background: Patients with ESCC always be discovered at an advanced stage and have a poor prognosis. The Circulating Tumor Cells (CTCs) were investigated for use as a biomarker for diagnosis and assessing the effectiveness of treatment. This study aims to investigate the predictive value of the baseline level of folate receptor-positive circulating tumor cells (FR+CTCs) for disease-free survival (DFS) and overall survival (OS) in patients with esophageal squamous cell carcinomas (ESCC). Methods: A retrospective observational study was conducted from January 2018 to February 2021 and followed up to June 2022 with ESCC patients in Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database (SCCH-ECCM Database). Three ml of peripheral blood were obtained from each patient, and FR+CTCs were quantified using ligand-targeted polymerase chain reaction (LT-PCR). Traditional techniques were employed to measure other serum markers. Clinicopathological features were collected from the hospital medical record system, and survival data (DFS and OS) were obtained by outpatient follow-up or phone calls. The correlation between clinicopathological characteristics, survival data, and FR+CTCs was analyzed. Cox regression analysis was used to assess risk factors that might have an impact on DFS and OS. Results: Analysis was conducted on 123 ESCC patients. Of them, 86% were men, and their average age was 62.0. FR+CTCs did not significantly correlate with patient age, sex, albumin, pre-albumin, C-reactive protein (CRP), ferritin, tumor size, grade of differentiation, metastasis of lymph nodes, perineural invasion/vessel invasion, or tumor size (all P>0.05). But for DFS (HR 3.29; 95% CI 1.52-7.15, P=0.003) and OS (HR 3.85; 95% CI 1.53-9.72, P=0.004), preoperative FR+CTCs were an independent prognostic factor. Patients with post-operative FR+CTCs ≥17.42 FU/3ml had a substantially shorter DFS than patients with FR+CTCs < 17.42 FU/3ml (P=0.0012). Patients with FR+CTCs ≥17.42 FU/3ml had a shorter OS than patients with FR+CTCs <17.42 FU/3ml, although the difference was not statistically significant (P=0.51). Conclusions: Patients with ESCC who have elevated FR+CTCs typically have a poorer prognosis. We anticipate that FR+CTCs will be able to guide clinical treatment, assess patient prognosis, and monitor cancer recurrence and metastasis in real-time.