Hospital A.C. Camargo Cancer Center, Centro de Pesquisa Internacional - São Paulo - SP - Brasil.
Arq Bras Cir Dig. 2022 Jan 31;34(4):e1628. doi: 10.1590/0102-672020210002e1628. eCollection 2022.
Ductal adenocarcinoma of the pancreas is the fourth most common cancer-associated cause of death in the Western world. The presence of circulating tumor cells (CTCs) can be considered a potential prognostic factor, as these cells represent tumor progression, allowing monitoring of therapeutic efficacy. The objectives of this study were to explore the morphological, molecular, and phenotypic characteristics of CTCs from the blood of patients with pancreatic carcinoma and to correlate the findings with response to treatment, progression-free survival, overall survival (OS), and deep vein thrombosis (DVT).
Peripheral blood (10 mL) was analyzed before the beginning of treatment after 60 and 120 days. CTCs were detected by using ISET® and characterized by immunocytochemistry. For microRNAs (miRNAs) analysis, peripheral leukocytes from the same patients and healthy individuals (controls) were collected in parallel at baseline. The expression of miRNAs was evaluated (in pool) using TaqMan® Array Human MicroRNA Cards v2.0.
Only nine patients were included. The proteins, namely, matrix metalloproteinase-2 (MMP2) and TGFβ-RI, were highly expressed (77.7%) in CTCs at baseline; at the first follow-up, MMP2 was predominant (80%) and, at the second follow-up, MMP2 and vimentin were predominant (50%). Circulating tumor microemboli (CTMs) were found in two patients and both presented DVT. The miR-203a-3p was highly expressed in CTCs. The miR-203a-3p is involved in the stimulation of epithelial-to-mesenchymal transition (EMT) and is related to worse OS in pancreatic cancer (TCGA data).
Due to the low number of patients and short follow-up, we did not observe a correlation between CTCs and response to treatment. However, there was a correlation between CTM and DVT and also miR-203a-3p was highly expressed in CTCs, corroborating the findings of EMT proteins. This study opens the perspectives concerning the dynamic change in the pattern of proteins expressed along with treatment and the use of miRNAs as new targets in pancreatic carcinoma.
胰腺导管腺癌是西方世界第四种常见的癌症相关死亡原因。循环肿瘤细胞(CTC)的存在可以被认为是一个潜在的预后因素,因为这些细胞代表肿瘤的进展,允许监测治疗的疗效。本研究的目的是探索来自胰腺癌患者血液中的 CTC 的形态、分子和表型特征,并将这些发现与治疗反应、无进展生存期、总生存期(OS)和深静脉血栓形成(DVT)相关联。
在治疗开始前、治疗后 60 天和 120 天分别分析 10ml 外周血。通过 ISET®检测 CTCs,并通过免疫细胞化学进行特征分析。为了进行 microRNAs(miRNAs)分析,在基线时同时从同一患者和健康个体(对照)收集外周白细胞。使用 TaqMan®Array Human MicroRNA Cards v2.0 评估 miRNAs 的表达(pool)。
仅纳入了 9 名患者。在基线时,蛋白质基质金属蛋白酶-2(MMP2)和 TGFβ-RI 在 CTCs 中高度表达(77.7%);在第一次随访时,MMP2 占主导地位(80%),在第二次随访时,MMP2 和波形蛋白占主导地位(50%)。两名患者发现循环肿瘤微栓子(CTMs),且两者均出现 DVT。miR-203a-3p 在 CTCs 中高表达。miR-203a-3p 参与刺激上皮-间充质转化(EMT),并与胰腺癌的总生存期较差相关(TCGA 数据)。
由于患者数量少且随访时间短,我们没有观察到 CTCs 与治疗反应之间的相关性。然而,CTM 与 DVT 之间存在相关性,并且 miR-203a-3p 在 CTCs 中高表达,这与 EMT 蛋白的发现相符。本研究为治疗过程中表达模式的动态变化以及将 miRNAs 作为胰腺癌的新靶点提供了新的视角。