Clinical significance of detecting circulating tumor cells in colorectal cancer using subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH)
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Wei Wu1,*, Zhenzhen Zhang2,*, Xian Hua Gao3,*, Zhen Shen1, Yan Jing1, Haibo Lu1, Heng Li1, Xiaoye Yang1, Xiangbin Cui1, Yuqing Li1, Zheng Lou3, Peng Liu3, Cun Zhang1, Wei Zhang3
1Department of General Surgery, The Aviation Hanzhong 3201 Hospital, Xi’an Jiao Tong University, Hanzhong 723000, Shaanxi, China
2Zhangjiang Center for Translational Medicine, Shanghai 200120, China
3Department of Colorectal Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
*These authors have contributed equally to this work
Wei Zhang, email: [email protected]
Cun Zhang, email: [email protected]
Keywords: colorectal cancer, circulating tumor cells, biomarker, recurrence, FISH
Received: October 04, 2016 Accepted: January 27, 2017 Published: February 17, 2017
Circulating tumor cells (CTC) are useful in early detection of colorectal cancer. This study described a newly developed platform, integrated subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH), to assess CTCs in colorectal cancer. CTCs were detected by SE-iFISH in 40 of 44 preoperative colorectal cancer patients, and yielded a sensitivity of 90.9%, which was significantly higher than CellSearch system (90.9% vs. 43.2%, P=0.033). No significant association was found between tumor stage, survival and preoperative CTC number. CTCs were detected in 10 colorectal cancer patients one week after surgery; seven patients with decreased CTC numbers (compared with preoperative CTC number) were free of recurrence; whereas two of the three patients with increased CTC numbers had tumor recurrence. Moreover, CTCs were detected in 34 colorectal cancer patients three months after surgery; patients with CTC<2 at three months after surgery had significantly longer Progression Free Survival than those with CTC>=2 (P=0.019); patients with decreased CTC number (compared with preoperative CTC number) had significantly longer Progression Free Survival than those with increased CTC number (P=0.003). In conclusion, CTCs could be detected in various stages of colorectal cancer using SE-iFISH. Dynamic monitoring of CTC numbers could predict recurrence and prognosis.
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