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Clinical significance of CDX2-positive circulating tumour cells in colorectal cancer patients.

Wong SC, Ng SS, Cheung MT, Luk LY, Chan CM, Cheung AH, Lee VH, Lai PB, Ma BB, Hui EP, Lam MY, Au TC, Chan AT - Br. J. Cancer (2011)

Bottom Line: Statistical analysis was used to correlate CDX2 pCTCs to the clinicohistopathological factors, recurrence, metastasis and survival after follow-up for 42 months in CRC patients.CDX2 pCTCs were detected in 81% CRC patients (73 out of 90, median number=21.5 CTCs), 7.5% CAD patients (3 out of 40), 0% patients with BCD (0 out of 90), 2.5% patients with OCC (2 out of 80) and 0% NS (0 out of 40).Using the median CDX2 pCTC numbers as the cutoff points, stratified groups of CRC patients had significant differences in their recurrence and survival.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory in Oncology in South China, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. cesar01@netvigator.com

ABSTRACT

Background: Our recent work has shown the feasibility of using a refined immunomagnetic enrichment (IE) assay to detect cytokeratin 20-positive circulating tumour cells (CK20 pCTCs) in colorectal cancer (CRC) patients. We attempted to improve the sensitivity for CRC by detecting another intestinal-type differentiation marker, CDX2 pCTCs, using the same methodology.

Methods: CDX2 pCTCs were detected in patients with CRC, colorectal adenoma (CAD), benign colorectal diseases (BCD), other common cancers (OCC) and normal subjects (NS). Statistical analysis was used to correlate CDX2 pCTCs to the clinicohistopathological factors, recurrence, metastasis and survival after follow-up for 42 months in CRC patients.

Results: CDX2 pCTCs were detected in 81% CRC patients (73 out of 90, median number=21.5 CTCs), 7.5% CAD patients (3 out of 40), 0% patients with BCD (0 out of 90), 2.5% patients with OCC (2 out of 80) and 0% NS (0 out of 40). Furthermore, statistical analysis showed that CDX2 pCTC numbers were associated with tumour- node-metastasis stage and lymph node status. Using the median CDX2 pCTC numbers as the cutoff points, stratified groups of CRC patients had significant differences in their recurrence and survival.

Conclusions: This study showed that the refined IE assay can detect CDX2 pCTCs with high sensitivity and that CDX2 pCTCs can generate clinically important information for CRC patients.

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Related in: MedlinePlus

Overall survival analysis for 45 CRC patients with (A) CDX2 pCTCs ⩽21.5 and (B) 45 CRC patients with CDX2 pCTCs >21.5.
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fig3: Overall survival analysis for 45 CRC patients with (A) CDX2 pCTCs ⩽21.5 and (B) 45 CRC patients with CDX2 pCTCs >21.5.

Mentions: Overall survival curves were plotted for patients with pretreatment CDX2 pCTCs >21.5 and those with pretreatment CDX2 pCTCs ⩽21.5, where 21.5 is the median number of pretreatment CDX2 pCTCs from the first cohort of 90 CRC patients. Our results showed that the survival rates for those two groups of patients were significantly different (P<0.0001, log-rank test; Figure 3). Moreover, the independent prognostic factors of OS identified by the Cox's proportional hazards regression model were found to be pretreatment CDX2 pCTCs (P=0.003) and lymph node status (P=0.022; Table 2). Furthermore, the OS in stages I–III patients stratified by the median number of preoperative CDX2 pCTCs of 13.5 had significant difference (P<0.05, log-rank test; Figure 4). Among the nine patients who had increased postoperative number of CDX2 pCTCs, two were stage III and seven were stage II. Follow-up for 42 months showed that one stage III patient and two stage II patients died of disease, whereas one stage III patient and two stage II patients had disease progression of either recurrence or metastasis. Stratifying the patients into subgroups indicated significant differences in DFS between (a) patients with negative preoperative CDX2 pCTCs and those with positive preoperative CDX2 pCTCs and increased postoperative level (P<0.001, log-rank test; Figure 5) and (b) patients with positive preoperative CDX2 pCTCs and decreased postoperative level and those with positive preoperative CDX2 pCTCs and increased postoperative level (P<0.005, log-rank test; Figure 5).


Clinical significance of CDX2-positive circulating tumour cells in colorectal cancer patients.

Wong SC, Ng SS, Cheung MT, Luk LY, Chan CM, Cheung AH, Lee VH, Lai PB, Ma BB, Hui EP, Lam MY, Au TC, Chan AT - Br. J. Cancer (2011)

Overall survival analysis for 45 CRC patients with (A) CDX2 pCTCs ⩽21.5 and (B) 45 CRC patients with CDX2 pCTCs >21.5.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065272&req=5

fig3: Overall survival analysis for 45 CRC patients with (A) CDX2 pCTCs ⩽21.5 and (B) 45 CRC patients with CDX2 pCTCs >21.5.
Mentions: Overall survival curves were plotted for patients with pretreatment CDX2 pCTCs >21.5 and those with pretreatment CDX2 pCTCs ⩽21.5, where 21.5 is the median number of pretreatment CDX2 pCTCs from the first cohort of 90 CRC patients. Our results showed that the survival rates for those two groups of patients were significantly different (P<0.0001, log-rank test; Figure 3). Moreover, the independent prognostic factors of OS identified by the Cox's proportional hazards regression model were found to be pretreatment CDX2 pCTCs (P=0.003) and lymph node status (P=0.022; Table 2). Furthermore, the OS in stages I–III patients stratified by the median number of preoperative CDX2 pCTCs of 13.5 had significant difference (P<0.05, log-rank test; Figure 4). Among the nine patients who had increased postoperative number of CDX2 pCTCs, two were stage III and seven were stage II. Follow-up for 42 months showed that one stage III patient and two stage II patients died of disease, whereas one stage III patient and two stage II patients had disease progression of either recurrence or metastasis. Stratifying the patients into subgroups indicated significant differences in DFS between (a) patients with negative preoperative CDX2 pCTCs and those with positive preoperative CDX2 pCTCs and increased postoperative level (P<0.001, log-rank test; Figure 5) and (b) patients with positive preoperative CDX2 pCTCs and decreased postoperative level and those with positive preoperative CDX2 pCTCs and increased postoperative level (P<0.005, log-rank test; Figure 5).

Bottom Line: Statistical analysis was used to correlate CDX2 pCTCs to the clinicohistopathological factors, recurrence, metastasis and survival after follow-up for 42 months in CRC patients.CDX2 pCTCs were detected in 81% CRC patients (73 out of 90, median number=21.5 CTCs), 7.5% CAD patients (3 out of 40), 0% patients with BCD (0 out of 90), 2.5% patients with OCC (2 out of 80) and 0% NS (0 out of 40).Using the median CDX2 pCTC numbers as the cutoff points, stratified groups of CRC patients had significant differences in their recurrence and survival.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory in Oncology in South China, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. cesar01@netvigator.com

ABSTRACT

Background: Our recent work has shown the feasibility of using a refined immunomagnetic enrichment (IE) assay to detect cytokeratin 20-positive circulating tumour cells (CK20 pCTCs) in colorectal cancer (CRC) patients. We attempted to improve the sensitivity for CRC by detecting another intestinal-type differentiation marker, CDX2 pCTCs, using the same methodology.

Methods: CDX2 pCTCs were detected in patients with CRC, colorectal adenoma (CAD), benign colorectal diseases (BCD), other common cancers (OCC) and normal subjects (NS). Statistical analysis was used to correlate CDX2 pCTCs to the clinicohistopathological factors, recurrence, metastasis and survival after follow-up for 42 months in CRC patients.

Results: CDX2 pCTCs were detected in 81% CRC patients (73 out of 90, median number=21.5 CTCs), 7.5% CAD patients (3 out of 40), 0% patients with BCD (0 out of 90), 2.5% patients with OCC (2 out of 80) and 0% NS (0 out of 40). Furthermore, statistical analysis showed that CDX2 pCTC numbers were associated with tumour- node-metastasis stage and lymph node status. Using the median CDX2 pCTC numbers as the cutoff points, stratified groups of CRC patients had significant differences in their recurrence and survival.

Conclusions: This study showed that the refined IE assay can detect CDX2 pCTCs with high sensitivity and that CDX2 pCTCs can generate clinically important information for CRC patients.

Show MeSH
Related in: MedlinePlus