Evaluation of circulating tumor cells in colorectal cancer using flow cytometry

• Published in: Journal of international medical research Vol. 49; no. 9; p. 300060520980215
• Main Authors: Mușină, Ana-Maria, Zlei, Mihaela, Mentel, Mihaela, Scripcariu, Dragoș-Viorel, Ștefan, Mădălina, Aniţei, Maria-Gabriela, Filip, Bogdan, Radu, Iulian, Gavrilescu, Mihaela-Mădălina, Panuţa, Andrian, Buna-Arvinte, Mihaela, Cordun, Cristiana-Ioana, Predescu, Dragoș-Valentin, Scripcariu, Viorel, Huţanu, Ionuţ
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Colorectal cancer; Flow cytometry; Prospective Clinical Research Report; circulating tumor cell; intraoperative tumor manipulation; flow cytometry; surgical resection; liquid biopsy; Colorectal cancer
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520980215

Objective We aimed to evaluate the prognostic value of circulating tumor cells (CTCs) and the impact of intraoperative tumor manipulation on CTCs in colorectal cancer (CRC) patients. Methods We performed a prospective study on 40 patients with CRC stages I to IV who received curative surgery using the no-touch technique. Flow cytometry was used to identify CTCs in peripheral blood samples (4 mL/sample) collected at two surgical moments: skin incision (T1) and after surgical resection (T2). A threshold of ≥4 CTCs/4 mL blood was established for considering patients CTC positive. Results In the univariate analysis, CTC evaluation at T2 was correlated with female sex, vascular invasion, tumor localization in the colon and metastatic lymph nodes. In the multivariate analysis, only female sex and colon cancer maintained statistical significance. At a medium follow-up of 15 months (1–25 months), the mortality rate was 10% (n = 4), with no significant differences between the overall survival of T1 or T2 CTC-positive and CTC-negative patients. Conclusions Flow cytometry is a feasible CTC identification technique in CRC, and although surgical manipulation has no influence on CTC numbers, CTCs may serve as a prognostic and predictive factor.