Apoptotic circulating tumor cells (CTCs) in the peripheral blood of metastatic colorectal cancer patients are associated with liver metastasis but not CTCs
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Joshua E. Allen1, Bikramajit Singh Saroya1, Miriam Kunkel1, David T. Dicker1, Avisnata Das1, Kristi L. Peters1, Jamal Joudeh1, Junjia Zhu1, and Wafik S. El-Deiry1
1 Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA
Wafik S. El-Deiry, email:
Keywords: CTC, colon cancer, colorectal cancer, metastasis, prognostic marker, apoptosis
Received: October 8, 2013 Accepted: October 15, 2013 Published: October 17, 2013
Enumeration of circulating tumor cells (CTCs) by the CellSearch system provides prognostic information in metastatic colorectal cancer, regardless of metastatic site. We found that CTCs generally represent <1% of observed events with CellSearch analysis and adapted scoring criteria to classify other peripheral blood events. Examination of twenty two metastatic colorectal cancer patients’ blood revealed that patients with high CEA or liver metastases, but not lung or distant lymph node metastases, possessed significant numbers of apoptotic CTCs prior to treatment initiation by Fischer’s exact test. Six out of eleven patients with liver metastasis possessed apoptotic CTCs whereas one of nine patients with other metastases had measurable apoptotic CTCs. An elevated CTC number was not necessarily associated with apoptotic CTCs or CTC debris by Spearman’s correlation, suggesting the metastatic site rather than CTCs per se as contributing to the origin of these events.
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