Gironda Daniel J, Adams Daniel L, He Jianzhong, Xu Ting, Gao Hui, Qiao Yawei, Komaki Ritsuko, Reuben James M, Liao Zhongxing, Blum-Murphy Mariela, Hofstetter Wayne L, Tang Cha-Mei, Lin Steven H
Rutgers, The State University of New Jersey, 77 Hamilton Street, New Brunswick, NJ, 08901, USA.
Creatv MicroTech Inc, Monmouth Junction, 9 Deer Park Dr, Potomac, NJ, 08852, USA.
J Transl Med. 2020 Nov 4;18(1):413. doi: 10.1186/s12967-020-02563-x.
Cancer Associated Macrophage-Like cells (CAMLs) are polynucleated circulating stromal cells found in the bloodstream of numerous solid-tumor malignancies. Variations within CAML size have been associated with poorer progression free survival (PFS) and overall survival (OS) in a variety of cancers; however, no study has evaluated their clinical significance in esophageal cancer (EC).
To examine this significance, we ran a 2 year prospective pilot study consisting of newly diagnosed stage I-III EC patients (n = 32) receiving chemoradiotherapy (CRT). CAML sizes were sequentially monitored prior to CRT (BL), ~ 2 weeks into treatment (T1), and at the first available sample after the completion of CRT (T2).
We found CAMLs in 88% (n = 28/32) of all patient samples throughout the trial, with a sensitivity of 76% (n = 22/29) in pre-treatment screening samples. Improved 2 year PFS and OS was found in patients with CAMLs < 50 μm by the completion of CRT over patients with CAMLs ≥ 50 μm; PFS (HR = 12.0, 95% CI = 2.7-54.1, p = 0.004) and OS (HR = 9.0, 95%CI = 1.9-43.5, p = 0.019).
Tracking CAML sizes throughout CRT as a minimally invasive biomarker may serve as a prognostic tool in mapping EC progression, and further studies are warranted to determine if presence of these cells prior to treatment suggest diagnostic value for at-risk populations.
癌症相关巨噬细胞样细胞（CAMLs）是在多种实体瘤恶性肿瘤患者血液中发现的多核循环基质细胞。在多种癌症中，CAML大小的变化与无进展生存期（PFS）和总生存期（OS）较差有关；然而，尚无研究评估其在食管癌（EC）中的临床意义。
为了研究这种意义，我们进行了一项为期2年的前瞻性试点研究，纳入了32例新诊断的I-III期EC患者，这些患者接受了放化疗（CRT）。在CRT之前（基线）、治疗约2周时（T1）以及CRT完成后的首个可用样本时（T2），对CAML大小进行连续监测。
在整个试验中，我们在所有患者样本的88%（n = 28/32）中发现了CAMLs，在治疗前筛查样本中的敏感性为76%（n = 22/29）。与CAMLs≥50μm的患者相比，CRT完成时CAMLs＜50μm的患者2年PFS和OS得到改善；PFS（风险比[HR]=12.0，95%置信区间[CI]=2.7-54.1，p = 0.004）和OS（HR = 9.0，95%CI = 1.9-43.5，p = 0.019）。
在整个CRT过程中追踪CAML大小作为一种微创生物标志物，可能作为预测EC进展的预后工具，有必要进一步研究以确定治疗前这些细胞的存在是否对高危人群具有诊断价值。
