Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients

Jussuf T. Kaifi, Miriam Kunkel, Junjia Zhu, David T. Dicker, Niraj J. Gusani, Zhaohai Yang, Nabeel E. Sarwani, Guangfu Li, Eric T. Kimchi, Kevin F. Staveley-O'Carroll, Wafik S. El-Deiry

Research output: Contribution to journalArticle

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Abstract

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States when combining both genders. Circulating tumor cells (CTCs) are a prognostic marker for stage IV CRC patients. We hypothesized that CTC quantity varies among stage IV CRC populations. Methods: Blood (7.5 ml) was prospectively collected from 90 stage IV CRC patients. EpCAM+ CTCs were analyzed with the FDA-approved CellSearchR system. CRC tumors were immunohistochemically stained for EpCAM expression. Imaging and clinicopathological data were collected. Statistical analysis was performed using correlation analysis, Kruskal-Wallis, Fisher exact, and log-rank test. Results: CTCs were detectable in 36/90 (40%) patients. Diffuse CRC metastases were associated with the highest CTC prevalence (24/40 [60%]), in contrast to limited lung (2/19 [11%]) or liver (10/31 [32%]) metastases (P = 0.027). The overall mean CTC number was 2.0 (range 0-56.3). The mean CTC number in patients with diffuse metastases was significantly higher (3.7 [SE M ± 1.7, range 0-56.3]) than with limited lung metastases (0.1 [± 0.1; range 0-1]) or liver metastases (0.9 [± 0.3, range 0-7.0]) (P = 0.001). CRC tumors were consistently expressing EpCAM. CTC numbers did not correlate with serum CEA levels or other routine clinical parameters (P = N.S.). Patients with diffuse metastases had the poorest overall survival (P = 0.0042). Conclusions: CRC patients with diffuse metastases have the highest number of CTCs, in contrast to limited metastases to the liver or lungs. Future studies should correlate CTCs with recurrence patterns in patients with resected CRC lung or liver metastases to investigate whether CTCs represent micrometastatic disease causing early relapses.

Original languageEnglish (US)
Pages (from-to)1174-1181
Number of pages8
JournalCancer Biology and Therapy
Volume14
Issue number12
DOIs
StatePublished - Dec 1 2013

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Circulating Neoplastic Cells
Colorectal Neoplasms
Neoplasm Metastasis
Cell Count
Lung
Liver
Recurrence
Liver Neoplasms
Lung Neoplasms

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

Cite this

Kaifi, Jussuf T. ; Kunkel, Miriam ; Zhu, Junjia ; Dicker, David T. ; Gusani, Niraj J. ; Yang, Zhaohai ; Sarwani, Nabeel E. ; Li, Guangfu ; Kimchi, Eric T. ; Staveley-O'Carroll, Kevin F. ; El-Deiry, Wafik S. / Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients. In: Cancer Biology and Therapy. 2013 ; Vol. 14, No. 12. pp. 1174-1181.
@article{bee22c5bb30541958ce4db5e647a5d5e,
title = "Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients",
abstract = "Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States when combining both genders. Circulating tumor cells (CTCs) are a prognostic marker for stage IV CRC patients. We hypothesized that CTC quantity varies among stage IV CRC populations. Methods: Blood (7.5 ml) was prospectively collected from 90 stage IV CRC patients. EpCAM+ CTCs were analyzed with the FDA-approved CellSearchR system. CRC tumors were immunohistochemically stained for EpCAM expression. Imaging and clinicopathological data were collected. Statistical analysis was performed using correlation analysis, Kruskal-Wallis, Fisher exact, and log-rank test. Results: CTCs were detectable in 36/90 (40{\%}) patients. Diffuse CRC metastases were associated with the highest CTC prevalence (24/40 [60{\%}]), in contrast to limited lung (2/19 [11{\%}]) or liver (10/31 [32{\%}]) metastases (P = 0.027). The overall mean CTC number was 2.0 (range 0-56.3). The mean CTC number in patients with diffuse metastases was significantly higher (3.7 [SE M ± 1.7, range 0-56.3]) than with limited lung metastases (0.1 [± 0.1; range 0-1]) or liver metastases (0.9 [± 0.3, range 0-7.0]) (P = 0.001). CRC tumors were consistently expressing EpCAM. CTC numbers did not correlate with serum CEA levels or other routine clinical parameters (P = N.S.). Patients with diffuse metastases had the poorest overall survival (P = 0.0042). Conclusions: CRC patients with diffuse metastases have the highest number of CTCs, in contrast to limited metastases to the liver or lungs. Future studies should correlate CTCs with recurrence patterns in patients with resected CRC lung or liver metastases to investigate whether CTCs represent micrometastatic disease causing early relapses.",
author = "Kaifi, {Jussuf T.} and Miriam Kunkel and Junjia Zhu and Dicker, {David T.} and Gusani, {Niraj J.} and Zhaohai Yang and Sarwani, {Nabeel E.} and Guangfu Li and Kimchi, {Eric T.} and Staveley-O'Carroll, {Kevin F.} and El-Deiry, {Wafik S.}",
year = "2013",
month = "12",
day = "1",
doi = "10.4161/cbt.26884",
language = "English (US)",
volume = "14",
pages = "1174--1181",
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Kaifi, JT, Kunkel, M, Zhu, J, Dicker, DT, Gusani, NJ, Yang, Z, Sarwani, NE, Li, G, Kimchi, ET, Staveley-O'Carroll, KF & El-Deiry, WS 2013, 'Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients', Cancer Biology and Therapy, vol. 14, no. 12, pp. 1174-1181. https://doi.org/10.4161/cbt.26884

Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients. / Kaifi, Jussuf T.; Kunkel, Miriam; Zhu, Junjia; Dicker, David T.; Gusani, Niraj J.; Yang, Zhaohai; Sarwani, Nabeel E.; Li, Guangfu; Kimchi, Eric T.; Staveley-O'Carroll, Kevin F.; El-Deiry, Wafik S.

In: Cancer Biology and Therapy, Vol. 14, No. 12, 01.12.2013, p. 1174-1181.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Circulating tumor cells are associated with diffuse spread in stage IV colorectal cancer patients

AU - Kaifi, Jussuf T.

AU - Kunkel, Miriam

AU - Zhu, Junjia

AU - Dicker, David T.

AU - Gusani, Niraj J.

AU - Yang, Zhaohai

AU - Sarwani, Nabeel E.

AU - Li, Guangfu

AU - Kimchi, Eric T.

AU - Staveley-O'Carroll, Kevin F.

AU - El-Deiry, Wafik S.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States when combining both genders. Circulating tumor cells (CTCs) are a prognostic marker for stage IV CRC patients. We hypothesized that CTC quantity varies among stage IV CRC populations. Methods: Blood (7.5 ml) was prospectively collected from 90 stage IV CRC patients. EpCAM+ CTCs were analyzed with the FDA-approved CellSearchR system. CRC tumors were immunohistochemically stained for EpCAM expression. Imaging and clinicopathological data were collected. Statistical analysis was performed using correlation analysis, Kruskal-Wallis, Fisher exact, and log-rank test. Results: CTCs were detectable in 36/90 (40%) patients. Diffuse CRC metastases were associated with the highest CTC prevalence (24/40 [60%]), in contrast to limited lung (2/19 [11%]) or liver (10/31 [32%]) metastases (P = 0.027). The overall mean CTC number was 2.0 (range 0-56.3). The mean CTC number in patients with diffuse metastases was significantly higher (3.7 [SE M ± 1.7, range 0-56.3]) than with limited lung metastases (0.1 [± 0.1; range 0-1]) or liver metastases (0.9 [± 0.3, range 0-7.0]) (P = 0.001). CRC tumors were consistently expressing EpCAM. CTC numbers did not correlate with serum CEA levels or other routine clinical parameters (P = N.S.). Patients with diffuse metastases had the poorest overall survival (P = 0.0042). Conclusions: CRC patients with diffuse metastases have the highest number of CTCs, in contrast to limited metastases to the liver or lungs. Future studies should correlate CTCs with recurrence patterns in patients with resected CRC lung or liver metastases to investigate whether CTCs represent micrometastatic disease causing early relapses.

AB - Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States when combining both genders. Circulating tumor cells (CTCs) are a prognostic marker for stage IV CRC patients. We hypothesized that CTC quantity varies among stage IV CRC populations. Methods: Blood (7.5 ml) was prospectively collected from 90 stage IV CRC patients. EpCAM+ CTCs were analyzed with the FDA-approved CellSearchR system. CRC tumors were immunohistochemically stained for EpCAM expression. Imaging and clinicopathological data were collected. Statistical analysis was performed using correlation analysis, Kruskal-Wallis, Fisher exact, and log-rank test. Results: CTCs were detectable in 36/90 (40%) patients. Diffuse CRC metastases were associated with the highest CTC prevalence (24/40 [60%]), in contrast to limited lung (2/19 [11%]) or liver (10/31 [32%]) metastases (P = 0.027). The overall mean CTC number was 2.0 (range 0-56.3). The mean CTC number in patients with diffuse metastases was significantly higher (3.7 [SE M ± 1.7, range 0-56.3]) than with limited lung metastases (0.1 [± 0.1; range 0-1]) or liver metastases (0.9 [± 0.3, range 0-7.0]) (P = 0.001). CRC tumors were consistently expressing EpCAM. CTC numbers did not correlate with serum CEA levels or other routine clinical parameters (P = N.S.). Patients with diffuse metastases had the poorest overall survival (P = 0.0042). Conclusions: CRC patients with diffuse metastases have the highest number of CTCs, in contrast to limited metastases to the liver or lungs. Future studies should correlate CTCs with recurrence patterns in patients with resected CRC lung or liver metastases to investigate whether CTCs represent micrometastatic disease causing early relapses.

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U2 - 10.4161/cbt.26884

DO - 10.4161/cbt.26884

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JO - Cancer Biology and Therapy

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SN - 1538-4047

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