Zhao Jia-Xing, Liu Li-Ren, Yang Xiao-Yu, Liu Fang, Zhang Zhong-Guo
State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Biology, School of Life Sciences, Xiamen University, Xiamen 361002, China.
Department of Colorectal Cancer Oncological Surgery, Large-Scale Data Analysis Center of Cancer Precision Medicine, Cancer Hospital of Chinese Medical University, Liaoning Provincial Cancer Institute and Hospital, Shenyang 110042, China.
Oncotarget. 2017 Jul 1;8(40):67918-67932. doi: 10.18632/oncotarget.18912. eCollection 2017 Sep 15.
Circulating tumor cells (CTCs) are used for metastasis surveillance in cancer patients, but low detection rates limit their use in colorectal cancer (CRC). We investigated the distribution of CTCs in peripheral and portal blood of CRC patients, and analyzed the relationship between serum tumor CEA/CA19-9 markers and CTCs blood levels. CTC levels detected in first reflux/portal vein blood were higher than in peripheral blood, and liver reduced CTCs amount. CTCs-positive patients had increased serum CEA and CA 19-9 levels, and the CEA and CA 19-9 levels correlated with the CTCs levels. Even in non-metastatic CRC patients with barely detectable CTCs in peripheral blood, serum CA 19-9 levels correlated with the CTC levels in first reflux/portal vein blood. These results demonstrate that CTC detection in the first reflux vein/portal vein blood is more sensitive than in peripheral blood, suggesting that clinical diagnosis using the CellSearch System should be based on the CTC detection in first reflux vein blood due to the high detection rates. In addition, our results indicate that serum CA 19-9 levels may serve as a diagnostic marker for further evaluation of CTC levels in portal blood.
循环肿瘤细胞（CTCs）用于癌症患者的转移监测，但低检测率限制了其在结直肠癌（CRC）中的应用。我们研究了CRC患者外周血和门静脉血中CTCs的分布，并分析了血清肿瘤CEA/CA19-9标志物与CTCs血水平之间的关系。首次回流/门静脉血中检测到的CTCs水平高于外周血，且肝脏会减少CTCs数量。CTCs阳性患者的血清CEA和CA 19-9水平升高，且CEA和CA 19-9水平与CTCs水平相关。即使在非转移性CRC患者中，外周血中CTCs几乎检测不到，但血清CA 19-9水平与首次回流/门静脉血中的CTCs水平相关。这些结果表明，首次回流静脉/门静脉血中CTCs的检测比外周血更敏感，这表明由于检测率高，使用CellSearch系统进行临床诊断应基于首次回流静脉血中的CTCs检测。此外，我们的结果表明，血清CA 19-9水平可能作为进一步评估门静脉血中CTCs水平的诊断标志物。
