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Portal versus peripheral circulating tumor cells as prognostic biomarkers in patients with stage I-III pancreatic ductal adenocarcinoma

医学 循环肿瘤细胞 转移 阶段(地层学) 肿瘤科 内科学 外围设备 胃肠病学 癌症 病理 古生物学 生物
作者
Thaninee Prasoppokakorn,Roongruedee Chaiteerakij,Areeya Buntho,Praewphan Ingrungruanglert,Nipan Israsena,Wiriyaporn Rittitid,Phonthep Angsuwatcharakon,Parit Mekaroonkamol,Pradermchai Kongkam,Rungsun Rerknimitr
出处
期刊:Endoscopy [Thieme Medical Publishers (Germany)]
标识
DOI:10.1055/a-2535-7440
摘要

Background: Portal venous circulating tumor cells (CTCs) detection may better reflect vascular metastasis and predict micro-metastasis risk in PDAC than peripheral blood. We hypothesize that portal CTCs could better represent micro-metastasis and predict survival in PDAC patients. Methods: A single-center, prospective cohort study of patients with stage I-III PDAC was conducted. Portal venous blood was obtained via EUS-guided sampling, and peripheral blood was collected on the same day. CTCs were detected using EpCAM and mucin1 antibodies and reported as cells/8mL of blood. Results: Among 35 patients, portal and peripheral CTC detection rates were 94.3% and 82.9%, respectively. Advanced PDAC with loco-regional metastasis had higher portal CTCs than less aggressive disease (p<0.05), while peripheral CTCs showed no significant differences. During the 50-month follow-up, patients with portal CTCs≥8 had poorer survival (6.1 vs. 19.0 months, p=0.001) and patients with peripheral CTCs≥3 also had poorer survival (4.6 vs. 14.2 months, p=0.002). In multivariable analysis, both portal CTCs≥8 and peripheral CTCs≥3 showed significant adjusted associations with survival (aHRs 3.39 and 2.71; p=0.009 and 0.020). Conclusion: Higher CTC counts in both portal and peripheral systems were significantly associated with poorer survival in stage I-III PDAC; however, only portal CTCs reflected tumor aggression and loco-regional metastasis.
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