Choi Young Hoon, Hong Tae Ho, Yoon Seung Bae, Lee In Seok, Lee Myung Ah, Choi Ho Joong, Choi Moon Hyung, Jung Eun Sun
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Biomedicines. 2022 May 31;10(6):1289. doi: 10.3390/biomedicines10061289.
Circulating tumor cells (CTCs) are a promising prognostic biomarker for cancers. However, the paucity of CTCs in peripheral blood in early-stage cancer is a major challenge. Our study aimed to investigate whether portal venous CTCs can be a biomarker for early recurrence and poor prognosis in pancreatic cancer. Patients who underwent upfront curative surgery for resectable pancreatic cancer were consecutively enrolled in this prospective study. Intraoperatively, 7.5 mL of portal and peripheral blood was collected, and CTC detection and identification were performed using immunofluorescence staining. Peripheral blood CTC sampling was performed in 33 patients, of which portal vein CTC sampling was performed in 28. The median portal venous CTCs (2.5, interquartile ranges (IQR) 1−7.75) were significantly higher than the median peripheral venous CTCs (1, IQR 0−2, p < 0.001). Higher stage and regional lymph node metastasis were related with a larger number of CTCs (≥3) in portal venous blood. Patients with low portal venous CTCs (≤2) showed better overall (p = 0.002) and recurrence-free (p = 0.007) survival than those with high portal venous CTCs (≥3). If validated, portal CTCs can be used as a prognostic biomarker in patients with resectable pancreatic cancer.
循环肿瘤细胞（CTCs）是一种很有前景的癌症预后生物标志物。然而，早期癌症外周血中CTCs数量稀少是一个重大挑战。我们的研究旨在调查门静脉CTCs是否可作为胰腺癌早期复发和预后不良的生物标志物。接受可切除胰腺癌 upfront 根治性手术的患者连续纳入本前瞻性研究。术中采集7.5 mL门静脉血和外周血，采用免疫荧光染色进行CTCs检测和鉴定。33例患者进行了外周血CTCs采样，其中28例进行了门静脉CTCs采样。门静脉CTCs中位数（2.5，四分位数间距（IQR）1 - 7.75）显著高于外周静脉CTCs中位数（1，IQR 0 - 2，p < 0.001）。更高的分期和区域淋巴结转移与门静脉血中更多数量的CTCs（≥3）相关。门静脉CTCs数量低（≤2）的患者比门静脉CTCs数量高（≥3）的患者总体生存率（p = 0.002）和无复发生存率（p = 0.007）更好。如果得到验证，门静脉CTCs可作为可切除胰腺癌患者的预后生物标志物。
