Liu Chun, Yan Cheng, Zhang Weichang, Sun Yuxin, Lin Youjun, Cai Wenwu
Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, Hunan, 410011, P.R. China.
BMC Cancer. 2025 Apr 17;25(1):724. doi: 10.1186/s12885-025-14140-w.
The relationship between circulating tumor cells (CTCs) and patients with advanced gallbladder adenocarcinoma (aGA) has been rarely studied. This article was to demonstrate the enumeration, classification, and clinical application of CTCs in patients with aGA.
Peripheral blood samples were collected and CTCs were detected using the CanPatrol technique. T test, χ test, Wilcoxon rank sum test or Kruskal-Wallis test, log-rank test and Cox regression analysis were performed to conduct statistical analysis.
CTCs were detected at pre-treatment in 75.00% (27/36) of the patients. Both CTCs positive rate and CTCs enumeration at pre-treatment were significantly associated with clinicopathological parameters including Ca199 level (P = 0.014, P < 0.001 respectively), tumor differentiation (P = 0.007, P = 0.002 respectively), lymph infiltration (P = 0.010, P = 0.025 respectively), vascular infiltration (P = 0.007, P < 0.001 respectively), and distant metastasis (P = 0.015, P = 0.002 respectively). CTCs-positive patients had a significantly shorter OS (HR 0.335, 95% CI 0.165-0.678, P = 0.0023) and PFS (HR 0.364, 95% CI 0.179-0.739, P = 0.0024) than CTCs-negative patients. Mesenchymal CTCs enumeration was closely related to the chemotherapy response, and CTCs programmed cell death ligand-1 (PD-L1) was highly correlated with the immunotherapy response. Positive CTCs at pre-treatment was closely related to the poor OS (HR 0.089, 95% CI 0.020-0.399, P = 0.002) as well as distant metastasis (HR 0.159, 95% CI 0.041-0.610, P = 0.007), untreated with chemotherapy (HR 4.510, 95% CI 1.403-14.499, P = 0.011) and untreated with immunotherapy (HR 6.845, 95% CI 1.894-24.738, P = 0.003).
Pretreatment-positive CTCs was closely related to the poor prognosis in patients with aGA. Monitoring the subtype and phenotype of CTCs may be one of the means to assess tumor treatment response.
循环肿瘤细胞（CTC）与晚期胆囊腺癌（aGA）患者之间的关系鲜有研究。本文旨在阐述aGA患者中CTC的计数、分类及临床应用。
采集外周血样本，采用CanPatrol技术检测CTC。进行t检验、χ检验、Wilcoxon秩和检验或Kruskal-Wallis检验、对数秩检验及Cox回归分析以进行统计分析。
75.00%（27/36）的患者在治疗前检测到CTC。治疗前CTC阳性率及CTC计数均与包括Ca199水平（分别为P = 0.014，P < 0.001）、肿瘤分化（分别为P = 0.007，P = 0.002）、淋巴浸润（分别为P = 0.010，P = 0.025）、血管浸润（分别为P = 0.007，P < 0.001）及远处转移（分别为P = 0.015，P = 0.002）在内的临床病理参数显著相关。CTC阳性患者的总生存期（OS，HR 0.335，95%CI 0.165 - 0.678，P = 0.0023）和无进展生存期（PFS，HR 0.364，95%CI 0.179 - 0.739，P = 0.0024）均显著短于CTC阴性患者。间充质CTC计数与化疗反应密切相关，且CTC程序性细胞死亡配体-1（PD-L1）与免疫治疗反应高度相关。治疗前CTC阳性与较差的OS（HR 0.089，95%CI 0.020 - 0.399，P = 0.002）以及远处转移（HR 0.159，95%CI 0.041 - 0.610，P = 0.007）密切相关，与未接受化疗（HR 4.510，95%CI 1.403 - 14.499，P = 0.011）和未接受免疫治疗（HR 6.845，95%CI 1.894 - 24.738，P = 0.003）也密切相关。
治疗前CTC阳性与aGA患者的不良预后密切相关。监测CTC的亚型和表型可能是评估肿瘤治疗反应的手段之一。
