Clinical value of folate receptor-positive circulating tumor cells in patients with esophageal squamous cell carcinomas: a retrospective study

• Published in: BMC cancer Vol. 23; no. 1; pp. 1 - 1171
• Main Authors: Zhou, Qiang, He, Qiao, He, Wenwu, Wang, Chenghao, Liu, Guangyuan, Wang, Kangning, Li, Haojun, Li, Jialong, Xiao, Wenguang, Fang, Qiang, Peng, Lin, Han, Yongtao, Wang, Dongsheng, Leng, Xuefeng
• Format: Journal Article
• Language: English
• Published: London BioMed Central 30.11.2023; BMC
• Subjects: Albumin; Alcohol use; Biomarkers; C-reactive protein; Cancer therapies; Chemotherapy; Circulating tumor cells; Circulatory system; Decision making; Disease-free survival; Electron tubes; Esophageal cancer; Esophageal carcinoma; Esophageal squamous cell carcinomas; Ferritin; Folate receptor; Folic acid; Ligands; Lung cancer; Lymph nodes; Medical prognosis; Metastases; Metastasis; Overall survival; Patients; Polymerase chain reaction; Prognosis; Radiation therapy; Regression analysis; Risk factors; Squamous cell carcinoma; Surgery; Tumor cells; Tumors; Vitamin B; United States > US; China
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-023-11565-z

Abstract Background The aim of the study is to explore the role of preoperative folate receptor-positive circulating tumor cell (FR + CTC) levels in predicting disease-free survival (DFS) and overall survival (OS) in patients with esophageal squamous cell carcinomas (ESCC). Methods Three ml blood samples were prospectively drawn from ESCC patients, and ligand-targeted polymerase chain reaction (LT-PCR) was used for the quantification of FR + CTCs. Other serum indicators were measured by traditional methods. Clinicopathological characteristics were obtained from the hospital medical record system, DFS and OS data were obtained by follow-up. The correlation between clinico-pathological characteristics, DFS, and OS and FR + CTCs were analyzed, respectively. Risk factors potentially affecting DFS and OS were explored by Cox regression analysis. Results there were no significant correlations between FR + CTCs and patient age, sex, albumin, pre-albumin, C-reactive protein (CRP), ferritin and CRP/Albumin ratio, tumor size, grade of differentiation, lymph node metastasis, TNM stage, perineural invasion/vessel invasion (all P  > 0.05). Nevertheless, preoperative FR + CTCs were an independent prognostic factor for DFS (HR 2.7; 95% CI 1.31-, P  = 0.007) and OS (HR 3.37; 95% CI 1.06-, P  = 0.04). DFS was significantly shorter for patients with post-operative FR + CTCs ≥ 17.42 FU/3ml compared with patients < 17.42 FU/3ml ( P  = 0.0012). For OS, it was shorter for patients with FR + CTCs ≥ 17.42 FU/3ml compared with patients < 17.42 FU/3ml, however, the difference did not reach statistical significance ( P  = 0.51). Conclusions ESCC patients with high FR + CTCs tend to have a worse prognosis. FR + CTCs may monitor the recurrence of cancers in time, accurately assess patient prognosis, and guide clinical decision-making. Trial registration The study was approved by the Sichuan Cancer Hospital & Institute Ethics Committee (No. SCCHEC-02-2022-050).