Improved clinical sensitivity detection of circulating tumor cell assays using a dual selection strategy in women with epithelial ovarian cancer

SummaryCirculating tumor cells (CTCs) are rare (few cells per milliliter of blood) and mostly isolated as single cell CTCs (scCTCs). CTC clusters (cCTCs), even rarer, are of growing interest, notably because of their higher metastatic potential, but very difficult to isolate. Here, we introduce gravity-based microfiltration (GµF) for facile isolation of cCTCs. We identify cluster break-up as a confounding cause, and achieve ∼85% capture efficiency. GµF from orthotopic ovarian cancer mouse models and from 10 epithelial ovarian cancer (EOC) patients uncovered cCTCs in every case, with between 2-100+ cells. cCTCs represented between 5-30% of all CTC events, and 10-80% of captured CTCs were clustered; remarkably, in two patients, more CTCs were circulating as cCTCs than scCTCs. GµF uncovered the unexpected prevalence, frequency and sometimes large size of cCTCs in EOC patients with either metastatic and localized disease, and motivates additional studies to uncover their properties and role in disease progression.

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Clinical significance of circulating tumor cell related markers in patients with epithelial ovarian cancer before and after adjuvant chemotherapy

Scientific Reports ◽

10.1038/s41598-021-88780-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Meysam Yousefi ◽

Sara Rajaie ◽

Vahideh Keyvani ◽

Somayeh Bolandi ◽

Malihe Hasanzadeh ◽

...

Keyword(s):

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Clinical Significance ◽

Therapy Response ◽

Serum Levels ◽

Circulating Tumor Cell ◽

Tumor Stage ◽

Disease Stage ◽

Before And After

AbstractCirculating tumor cells (CTCs) have recently been considered as new prognostic and diagnostic markers for various human cancers; however, their significance in epithelial ovarian cancer (EOC) remains to be elucidated. In this study, using quantitative real-time PCR, we evaluated the expression of EPCAM, MUC1, CEA, HE4 and CA125 mRNAs, as putative markers of CTCs, in the blood of 51 EOC patients before and/or after adjuvant chemotherapy. Our results demonstrated that, before chemotherapy, the expression of EPCAM, MUC1, CEA and HE4 mRNAs were correlated to each other. CEA expression was correlated with tumor stage (r = 0.594, p = 0.000) before chemotherapy, whereas its expression after chemotherapy was correlated with serum levels of CA125 antigen (r = 0.658, p = 0.000). HE4 mRNA showed the highest sensitivity both before and after chemotherapy (82.98% and 85.19%, respectively) and the persistence of this marker after chemotherapy was associated with advanced disease stage. The expression of CA125 mRNA had negative correlation with the other markers and with tumor stage and therapy response (evaluated by the measurement of serum CA125 antigen). Collectively, our results indicated a better clinical significance of tumor-specific markers (CEA and HE4 mRNAs) compared to epithelial-specific markers (EPCAM and MUC1 mRNAs).

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