Vimentin-Positive Circulating Tumor Cells as Diagnostic and Prognostic Biomarkers in Patients with Biliary Tract Cancer.

Hyun Suk Ko,Hyung Il Seo,Gwang Ha Kim,So Jeong Lee,Sung Yong Han,Aelee Jang,Dong Uk Kim,Sung Hee Park

doi:10.3390/jcm10194435

Abstract

Biliary tract cancer (BTC) has poor prognosis; thus, early diagnosis is important to decrease mortality. Although vimentin-positive circulating tumor cells (V-CTCs) are a good candidate for diagnostic and prognostic biomarkers, studies on the topic are limited. We aimed to evaluate the diagnostic efficacy of V-CTCs between BTC and benign biliary disease (BBD) and determine the prognostic value of V-CTCs in BTC patients. We recruited 69 participants who had BTCs and BBDs from a single tertiary referral center. We analyzed CTCs and V-CTCs in peripheral blood using the CD-PRIMETM system. Seven patients were excluded due to a technical failure of CTC detection. CTCs were detected in all 62 patients. CTC count > 40/mL blood (55.8% vs. 20%, p = 0.039), V-CTC count > 15/mL blood (57.7% vs. 10%, p = 0.005), and V-CTC/CTC ratio > 40% (48.1% vs. 10%, p = 0.025) were significantly different between BTCs and BBDs. Two or more of these three parameters (61.5% vs. 10%, p = 0.002) increased the accuracy. A combination of CTC markers with CA19-9 and biopsy increased the accuracy (90.4% vs. 10%, p = 0.000). V-CTC > 50/mL blood was a significant factor affecting survival (140 (66.6–213.3) vs. 253 (163.9–342.1) days, p = 0.008). V-CTC could be a potential biomarker for early diagnosis and predicting prognosis in patients with BTC.

Highlights

Biliary tract cancer (BTC) is a rare type of cancer that occurs in 2–3 per 100,000 persons.The incidence is more than two times higher in northeast Asia than in other countries.the incidence is increasing worldwide, in western countries
The inclusion criteria for BTCs were (1) age ≥ 18 years; (2) BTC diagnosis based on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI); and (3) histological confirmation as adenocarcinoma
The inclusion criteria for BBDs were (1) age ≥ 18 years; (2) benign biliary diseases such as cholelithiasis and benign biliary stricture based on US, CT, and MRI; and (3) no history of other malignancies within 5 years

Summary

Introduction

Biliary tract cancer (BTC) is a rare type of cancer that occurs in 2–3 per 100,000 persons.The incidence is more than two times higher in northeast Asia than in other countries.the incidence is increasing worldwide, in western countries. Biliary tract cancer (BTC) is a rare type of cancer that occurs in 2–3 per 100,000 persons. The incidence is more than two times higher in northeast Asia than in other countries. The incidence is increasing worldwide, in western countries. The mortality rate is relatively high compared to those of other gastrointestinal malignancies, despite the development of therapeutic agents [1,2,3,4,5]. The poor prognosis of BTC is largely due to delayed diagnosis from late examination because of non-specific symptoms such as dyspepsia, weight loss, and abdominal discomfort in the early disease stage. BTC tissues are paucicellular with abundant fibrous stroma, leading to false negatives in pathology and resulting in late diagnosis and poor prognosis. An exact early diagnostic method is needed for the improvement of prognosis of BTC patients

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