Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
Dig Dis Sci. 2018 Sep;63(9):2373-2380. doi: 10.1007/s10620-018-5124-2. Epub 2018 Jun 21.
Circulating tumors cells (CTCs) may be a promising prognostic marker for patients with malignant tumors. However, there are few reports regarding its value for hepatocellular carcinoma (HCC) patients.
To investigate CTCs with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for HCC patients.
Peripheral blood samples were obtained from 165 HCC patients before radical surgery. CTCs were isolated via the CanPatrol CTC enrichment technique and classified using epithelial-mesenchymal transition (EMT) markers. The relationship of CTC phenotype with clinicopathological factors and HCC recurrence in patients was analyzed.
CTC-positive status (count ≥ 2/5 mL) was found in 70.9% of the 165 HCC patients. Increased CTC number was more common in patients with higher AFP levels, multiple tumors, advanced TNM and BCLC staging, and presence of embolus or microembolus (P < 0.05). CTCs heterogeneity was noted using EMT markers. Mesenchymal CTCs were significantly correlated with high AFP levels, multiple tumors, advanced TNM and BCLC stage, presence of embolus or microembolus, and earlier recurrence (P < 0.05). The presence of mesenchymal CTCs predicted the shortest relapse-free survival, followed by mixed phenotypic CTCs, and then epithelial CTCs (P < 0.001).
CTC phenotype may serve as a prognostic indicator for HCC patients. CTCs assessment should include phenotypic identification tailored to characterize cells based on epithelial and mesenchymal markers.
循环肿瘤细胞（CTCs）可能是恶性肿瘤患者有前途的预后标志物。然而，关于其对肝细胞癌（HCC）患者的价值的报道很少。
研究具有上皮和间充质表型的 CTCs 作为 HCC 患者的潜在预后生物标志物。
从 165 例接受根治性手术的 HCC 患者中采集外周血样本。使用 CanPatrol CTC 富集技术分离 CTCs，并使用上皮-间充质转化（EMT）标志物对其进行分类。分析 CTC 表型与患者临床病理因素和 HCC 复发的关系。
在 165 例 HCC 患者中，有 70.9%的患者 CTC 阳性（计数≥2/5 mL）。AFP 水平较高、肿瘤多发、TNM 和 BCLC 分期较晚、存在栓子或微栓子的患者，其 CTC 数量增加更为常见（P<0.05）。使用 EMT 标志物观察到 CTC 异质性。间充质 CTCs 与高 AFP 水平、肿瘤多发、TNM 和 BCLC 分期较晚、存在栓子或微栓子以及更早复发显著相关（P<0.05）。存在间充质 CTCs 预测无复发生存期最短，其次是混合表型 CTCs，然后是上皮 CTCs（P<0.001）。
CTC 表型可作为 HCC 患者的预后指标。CTC 评估应包括表型鉴定，根据上皮和间充质标志物对细胞进行特征化。
