CLINICAL POTENTIAL OF CIRCULATING TUMOR CELLS IN COLORECTAL CANCER: A PROSPECTIVE STUDY

Aims:

Identification of Circulating tumor cells (CTCs) in the peripheral blood has been suggested for an early diagnostic and prognostic marker in patient with colorectal cancer (CRC). However, only limited data exist on the diagnostic impact of CTCs in patients with CRC. In this study, we evaluate a newly developed CTCs detection systems based on the cell size to assess CTCs and its clinical potential with early diagnosis and prognostic biomarker in CRC patient.

Methods:

From 2014 to 2015, a total of 88 patients with newly diagnosed CRC (67 patients with colon cancer and 21 patients with rectal cancer) who were scheduled for surgery and 31 healthy volunteers were enrolled and followed-up in Pusan National University Hospital. CTCs were enriched using a centrifugal microfluidic system with a new fluid-assisted separation technique (FAST) from peripheral blood and were detected by cytomorphological evaluation using fluorescence microscopy.

Results:

Two or more CTCs were detected using FAST in 74 patients and 3 healthy volunteers. The number of CTCs in the CRC group was significantly higher than that in the healthy volunteers (P < 0.001). When a receiver operating characteristic curve was created to differentiate CRC patients from healthy volunteers, the sensitivity and specificity were almost optimized when the critical CTC value was 5/7.5 mL of blood. When this value was used, the sensitivity and specificity in differentiating CRC patients from the healthy controls were 75% and 100%, respectively. In CRC patients with ≥5 CTCs, vascular invasion was frequently identified (P = 0.035). All patients with stage IV cancer were positive for CTCs.

Conclusions:

Our study demonstrated promising results with the use of FAST-based CTC detection for the early diagnosis.