Date Published: June 29, 2017
Publisher: Public Library of Science
Author(s): Hwa Mi Kang, Gwang Ha Kim, Hye Kyung Jeon, Dae Hwan Kim, Tae Yong Jeon, Do Youn Park, Hyunjin Jeong, Won Joo Chun, Mi-Hyun Kim, Juhee Park, Minji Lim, Tae-Hyeong Kim, Yoon-Kyung Cho, Olorunseun Ogunwobi.
The use of circulating tumor cells (CTCs) as an early diagnostic biomarker and prognostic indicator after surgery or chemotherapy has been suggested for various cancers. This study aimed to evaluate CTCs in patients who underwent gastrectomy for gastric cancer and to explore their clinical usefulness in the early diagnosis of gastric cancer.
A total of 116 patients with gastric cancer who underwent gastrectomy and 31 healthy volunteers were prospectively included between 2014 and 2015. Peripheral blood samples were collected before gastrectomy, and CTCs were examined using a centrifugal microfluidic system with a new fluid-assisted separation technique.
After creating a receiver operating characteristic curve to identify the discriminative CTC value needed differentiate patients with gastric cancer from healthy volunteers, sensitivity and specificity were nearly optimized at a CTC threshold of 2 per 7.5 mL of blood. Of the 102 persons with a CTC level ≥2 per 7.5 mL of blood, 99 (97.1%) had gastric cancer, and of the 45 persons with a CTC level <2 per 7.5 mL of blood, 28 (62.2%) were healthy controls. Accordingly, the sensitivity and specificity for the differentiation of patients with gastric cancer from healthy controls were 85.3% and 90.3%, respectively. However, the presence of CTCs was not associated with any clinicopathologic features such as staging, histologic type, or mucin phenotype. Although we could not prove the clinical feasibility of CTCs for gastric cancer staging, our results suggest a potential role of CTCs as an early diagnostic biomarker of gastric cancer.
Gastric cancer is the fifth-most common malignancy and second-leading cause of cancer-related death worldwide . Although advances in surgery and adjuvant chemotherapy have improved the clinical prognoses of patients with gastric cancer , the 5-year survival rate remains <30%, and affected patients are hindered by recurrence and distant metastasis . In the present study, CTCs were identified in 105 (91%) of 116 patients with gastric cancer, and a threshold of ≥2 CTCs per 7.5 mL of blood was useful for differentiating patients with gastric cancer from healthy controls. However, no associations were observed between CTCs and clinicopathologic features such as histologic type, T stage, N stage, and mucin phenotype. To our knowledge, this is the first report to demonstrate FAST-based CTC detection as an early diagnostic biomarker for gastric cancer. Although the clinical feasibility of CTC assessment for gastric cancer staging was not proven, our study results suggest a potential role of FAST-based CTC detection as an early diagnostic biomarker of gastric cancer. These results should be further supported by additional large, prospective multi-center studies. In addition, the role of CTCs as a biomarker predictive of patients’ prognoses and responses to chemotherapy should be investigated during a long-term follow-up. Source: http://doi.org/10.1371/journal.pone.0180251