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J Cancer. 2018 May 22;9(11):2038-2045. doi: 10.7150/jca.23989. eCollection 2018.

Detection of CTCs in portal vein was associated with intrahepatic metastases and prognosis in patients with advanced pancreatic cancer.

Liu X1,2, Li C1,2, Li J1,2, Yu T1,2, Zhou G1,3, Cheng J1,2, Li G1,2, Zhou Y1,3, Lou W4,5, Wang X1,2, Gong G1,2, Liu L1,2, Chen Y1,2.

Author information

1
Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
2
Department of Interventional Radiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China.
3
Department of Radiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China.
4
Department of Pancreatic Surgery, Zhongshan Hospital Fudan University, 200032, China.
5
Department of General Surgery, Zhongshan Hospital Fudan University, 200032, China.

Abstract

Pancreatic cancer is amongst the most lethal malignancies with increasing incidence and mortality worldwide. Distant metastases, especially intrahepatic metastases, is the leading cause of death for pancreatic cancer. Circulating tumor cells (CTCs) are neoplastic cells released from the primary tumor into circulation, and play critical roles in metastases of various types of cancers. Though clinical studies showed that detection of CTCs in peripheral circulation was associated with worse prognosis in patients with breast cancer and hepatocellular carcinoma, detection CTCs in peripheral blood of pancreatic cancer was still challenging due to hepatic filtration and technical limitations. Previous studies have demonstrated that CTCs could be detected in portal vein circulation in patients with pancreaticobiliary carcinoma. In the present study, taking advantage of ultrasonography-guided transhepatic puncture, we analysis CTCs in portal vein blood obtained from patients with advanced pancreatic cancer. CTCs were detected in all 29-portal vein blood of samples, and absolute numbers of circulating pancreatic cancer cells in portal vein was significantly higher than that in peripheral circulation. Furthermore, we found that CTC counts in portal vein was highly associated with intrahepatic metastases and indicated poorer prognosis in patients with advanced pancreatic cancer. Short-term expansion and in vitro drug sensitivity assay showed that CTCs derived from portal vein blood were highly resistant to several chemotherapy regimens. In summary, detection of CTCs in portal vein could be a powerful tool to stratify the risk of intrahepatic metastases of pancreatic cancer, and provided new insight into the biological feature of pancreatic cancer metastases and drug resistance.

KEYWORDS:

circulating tumor cells; intrahepatic metastases; pancreatic cancer; portal vein

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

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