Research Papers:

Serum CA19-9 as a marker of circulating tumor cells in first reflux blood of colorectal cancer patients

Jia-Xing Zhao, Li-Ren Liu, Xiao-Yu Yang, Fang Liu and Zhong-Guo Zhang _

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Oncotarget. 2017; 8:67918-67932. https://doi.org/10.18632/oncotarget.18912

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Jia-Xing Zhao1,2,*, Li-Ren Liu3, Xiao-Yu Yang2, Fang Liu2 and Zhong-Guo Zhang2,*

1State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Biology, School of Life Sciences, Xiamen University, Xiamen 361002, China

2Department of Colorectal Cancer Oncological Surgery, Large-Scale Data Analysis Center of Cancer Precision Medicine, Cancer Hospital of Chinese Medical University, Liaoning Provincial Cancer Institute and Hospital, Shenyang 110042, China

3Department of Gastrointestinal Cancer Biology, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China

*These authors have contributed equally to this work

Correspondence to:

Zhong-Guo Zhang, email: [email protected]

Fang Liu, email: [email protected]

Keywords: CRC, colorectal cancer, CTC, circulating tumor cell, peripheral blood

Received: January 19, 2017    Accepted: May 23, 2017    Published: July 01, 2017


Circulating tumor cells (CTCs) are used for metastasis surveillance in cancer patients, but low detection rates limit their use in colorectal cancer (CRC). We investigated the distribution of CTCs in peripheral and portal blood of CRC patients, and analyzed the relationship between serum tumor CEA/CA19-9 markers and CTCs blood levels. CTC levels detected in first reflux/portal vein blood were higher than in peripheral blood, and liver reduced CTCs amount. CTCs-positive patients had increased serum CEA and CA 19-9 levels, and the CEA and CA 19-9 levels correlated with the CTCs levels. Even in non-metastatic CRC patients with barely detectable CTCs in peripheral blood, serum CA 19-9 levels correlated with the CTC levels in first reflux/portal vein blood. These results demonstrate that CTC detection in the first reflux vein/portal vein blood is more sensitive than in peripheral blood, suggesting that clinical diagnosis using the CellSearch System should be based on the CTC detection in first reflux vein blood due to the high detection rates. In addition, our results indicate that serum CA 19-9 levels may serve as a diagnostic marker for further evaluation of CTC levels in portal blood.

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