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Oncotarget. 2017 Feb 7;8(6):9293-9302. doi: 10.18632/oncotarget.14065.

Expression and clinical relevance of epithelial and mesenchymal markers in circulating tumor cells from colorectal cancer.

Author information

1
Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
2
Department of Laboratory Medicine, Sino-UK Circulating Biomarkers' Exploration and Detection Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
3
Department of General surgery, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
4
Department of Gastrointestinal Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
5
Department of General Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
6
SurExam Bio-Tech Co., Guangzhou, China.
7
Department of Gastrointestinal Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
8
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.

Abstract

Circulating tumor cells (CTCs) with phenotypic hallmarks of epithelial-mesenchymal transition (EMT) reportedly contribute to tumor metastasis in different cancer types. We therefore evaluated the expression of EMT markers in CTCs obtained from a large cohort of Chinese patients with colorectal cancer (CRC) and investigated their clinical relevance. The CanPatrolTM CTC enrichment technique was used to isolate and classify CTCs. CTCs were detected in 1046 of 1203 patients (86.9%), and three phenotypes were identified based on the expression of epithelial and mesenchymal markers: epithelial CTCs, biophenotypic (epithelial/mesenchymal) CTCs, and mesenchymal CTCs. Total CTC numbers positively correlated with both clinical stage and lymph node metastasis and distant metastasis. Furthermore, both biophenotypic and mesenchymal, but not epithelial, CTCs, correlated with the above parameters, suggesting CTCs displaying a mesenchymal phenotype denote more aggressive disease and metastatic potential. This is the first study to demonstrate a significant correlation between CTCs displaying a mesenchymal phenotype and both clinical stage and metastasis in a large cohort of patients with CRC. Our findings suggest that assessment of not only epithelial, but also mesenchymal markers in CTC analyses may offer valuable assistance for tumor staging and metastasis evaluation in patients with CRC.

KEYWORDS:

circulating tumor cells; clinical stage; colorectal cancer; epithelial-mesenchymal transition; metastasis

PMID:
28030836
PMCID:
PMC5354732
DOI:
10.18632/oncotarget.14065
[Indexed for MEDLINE]
Free PMC Article

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