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Int J Cancer. 2019 Mar 15;144(6):1421-1431. doi: 10.1002/ijc.31742. Epub 2018 Oct 26.

Clinical significance of circulating tumor cells in predicting disease progression and chemotherapy resistance in patients with gestational choriocarcinoma.

Author information

1
Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
2
Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
3
Department of Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
4
Department of Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
5
Department of Pathology, Guangdong Medical College, Dongguan, Guangdong, People's Republic of China.
6
School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China.
7
Biomedical Engineering, The University of Texas at El Paso, El Paso, TX.
8
Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.
9
Molecular Diagnosis Center, The Affiliated Zhongshan Hospital, Sun Yat-Sen University, Zhongshan, Guangdong, People's Republic of China.
10
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
11
Chapter Diagnostics, Menlo Park, CA.
12
MyGene Diagnostics, Guangzhou International Biotech Island, Guangdong, People's Republic of China.
13
Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
14
Pricision Medicine Center, Shenzhen People's Hospital, Shenzhen, Guangdong, People's Republic of China.
15
Department of Genetics, Harvard Medical School, Boston, MA.

Abstract

Gestational choriocarcinoma (GC) is a highly aggressive tumor. In our study, we systematically investigated EpCAM/CD147 expression characteristics in patients with GC and assessed the role of circulating tumor cells (CTCs) in predicting chemotherapy response and disease progression. GC tissues were positive for either epithelial cellular adhesion molecule (EpCAM) or CD147, and all samples exhibited strong human chorionic gonadotropin (HCG) expression. Among all the recruited patients (n = 115), 103 had at least 1 CTC in a 7.5-mL peripheral blood sample, and the percentage of patients with ≥4 CTCs in a particular FIGO stage group increased with a higher FIGO stage (p < 0.001). Furthermore, the pretreatment CTC count was related to tumor size (r = 0.225, p = 0.015) and the number of metastases (r = 0.603, p < 0.001). A progression analysis showed that among the 115 included patients who qualified for further examination, 52 of the 64 patients defined as progressive had ≥4 pretreatment CTCs, while only 7 of the 51 non-progressive patients had ≥4 pretreatment CTCs (p < 0.001). In multivariate analysis, CTCs (≥4) remained the strongest predictor of PFS when other prognostic markers, FIGO score and FIGO stage were included. Moreover, based on the chemotherapy response, patients with ≥4 CTCs were more likely to be resistant to chemotherapy than those with <4 CTCs (P < 0.001). These findings demonstrates the feasibility of CTC detection in cases of GC by adopting EpCAM/CD147 antibodies together as capturing antibodies. The CTC count is a promising indicator in the evaluation of biological activities and the chemotherapy response in GC patients.

KEYWORDS:

chemotherapy resistance; circulating tumor cell; gestational choriocarcinoma; progression; β-HCG

PMID:
30070688
DOI:
10.1002/ijc.31742
[Indexed for MEDLINE]

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