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Predictive value of circulating tumor cell counts during the treatment of cancer: interactions with the blood microenvironment

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Abstract

Objective

This study aimed to evaluate the prognostic value of circulating tumor cell (CTC) in tumor patients during treatment.

Methods

This study retrospectively analyzed clinical data obtained from 174 cancer patients during treatment. The relationship between the CTC counts and clinicopathological variables was analyzed. A ROC curve was applied to determine the optimal cut-off values and assess the predictive ability of the prognostic indicators. The overall survival (OS) for different prognostic factors was calculated using the Kaplan–Meier method, and the difference between the survival curves was then compared using the log-rank test. Cox regression model was used to investigate the effect of independent factors on patients’ survival.

Results

The CTC-positive rate was positively correlated with the clinicopathological variables of TNM stage, tumor differentiation, serum CEA level, and ki-67%. In the differential analysis of hematological microenvironment parameters in CTC-positive and CTC-negative samples, the complete blood count, blood biological chemistry, tumor markers (CEA, CA19-9, CA72-4), and lymphocyte subpopulation were statistically significant. The results of the ROC curve analysis indicated that the serum CEA level was the best diagnostic indicator to discriminate the CTC count in tumor patients. Additionally, the results of the univariate and multivariate analyses of OS in relation to clinical variables revealed that the CTC counts were an independent prognostic factor for unfavorable OS.

Conclusion

The CTC counts in patients with tumors undergoing treatment were significantly correlated with hematological microenvironment parameters. The detection of CTCs may therefore be used as an indicator of tumor prognosis.

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Data availability

The original contributions presented in the study are included in the article material. Further inquiries can be directed to the corresponding authors.

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Acknowledgements

None.

Funding

This work was supported by the National Natural Science Foundation of China (81872200, 31900558), the Hubei Provincial Youth Talents Program for Public Health (WSJKRC2022013), Wuhan Young and middle-aged medical backbone talents Training Project (WHQG201904), the Zhongnan Hospital of Wuhan University Science, Technology and Innovation Seed Fund (ZNPY2019002).

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Author notes

  1. Liu Yang, Xiaojiao Zeng, and Gui Yang have equally contributed to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, No.169 Donghu Road, Wuchang District, Wuhan, 430071, China

    Liu Yang, Xiaojiao Zeng, Gui Yang, Yirong Li & Yunbao Pan

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  1. Liu Yang
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  2. Xiaojiao Zeng
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  3. Gui Yang
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Contributions

Conceptualization: YP. Methodology: LY, XZ, GY and YP. Formal analysis: LY, XZ and YP. Investigation: YP, YL. Writing—original draft: LY. Writing—review and editing: YP. Supervision: YP and YL.

Corresponding authors

Correspondence to Yirong Li or Yunbao Pan.

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The authors have no conflicts of interest to declare.

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Cite this article

Yang, L., Zeng, X., Yang, G. et al. Predictive value of circulating tumor cell counts during the treatment of cancer: interactions with the blood microenvironment. Int J Clin Oncol 28, 1011–1022 (2023). https://doi.org/10.1007/s10147-023-02355-5

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  • DOI: https://doi.org/10.1007/s10147-023-02355-5

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