Clinical relevance of EMT and stem-like gene expression in circulating tumor cells of metastatic colorectal cancer patients.

Clinical relevance of EMT and stem-like gene expression in circulating tumor cells of metastatic colorectal cancer patients.
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DOI:
10.1038/tpj.2016.62
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发表时间:
2018-01
期刊:
The pharmacogenomics journal
影响因子:
--
通讯作者:
Lenz HJ
Lenz HJ
中科院分区:
其他
文献类型:
--
作者:
Ning Y;Zhang W;Hanna DL;Yang D;Okazaki S;Berger MD;Miyamoto Y;Suenaga M;Schirripa M;El-Khoueiry A;Lenz HJ

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使用经批准的方法,仅从 30%–50% 的转移性结直肠癌 (mCRC) 患者的血液中分离出循环肿瘤细胞 (CTC)。我们之前通过将 EpCAM+/CD45− 细胞的免疫磁性富集与 CK20 和生存素表达的 qRT-PCR 扩增相结合,验证了一种在 mCRC 患者队列中分离循环肿瘤细胞 (CTC) 的技术。在这里,我们检查了 CTC 上皮间质转化 (EMT) 和干细胞基因表达的预后效用。在接受研究性和标准化疗药物治疗之前,从 78 名连续转移性结直肠癌患者身上采集了 8 毫升血样。测量 EMT(PI3Ka、Akt-2、Twist1)和干细胞(ALDH1)标记物的 mRNA 表达。使用 Cox 回归模型确定 CTC 基因表达与无进展生存期 (PFS) 和总生存期 (OS) 之间的关联。在没有 CK20 或表达生存素的 CTC 的患者 (n = 17) 中,55% 表达 ALDH1、PI3Ka 和/或 Akt-2。在单变量(风险比 (HR) = 1.61;对数秩 P = 0.034)和多变量分析(HR = 1.70;调整后 P = 0.041)中,与 CTC Akt-2 不表达的患者相比,CTC Akt-2 表达阳性的患者的中位 PFS 显着缩短(3.0 个月与 4.0 个月)。在单变量分析中,CTC ALDH1 表达与较短的 OS 相关(10.0 个月与 38.6 个月;HR = 2.04,P = 0.021)。在单变量而非多变量分析中,表达 ALDH1、PI3Ka 和/或 Akt-2 的 CTC 患者的 PFS(3.0 个月对比 7.7 个月;HR= 1.88,P = 0.015)和 OS(10.0 个月对比 26.8+ 个月;HR = 2.25,P = 0.050)显着较差。结论:CTC Akt-2 表达可能作为 mCRC 患者临床上有用的预后标志物,值得在前瞻性试验中进一步评估。
Using approved methods, circulating tumor cells (CTCs) are only isolated from blood in 30%–50% of metastatic colorectal cancer (mCRC) patients. We previously validated a technique to isolate circulating tumor cells (CTCs) in a cohort of mCRC patients by combining immunomagnetic enrichment of EpCAM+/CD45− cells with qRT-PCR amplification of CK20 and survivin expression. Here, we examined the prognostic utility of CTC epithelial-mesenchymal transition (EMT) and stem cell gene expression. An 8 ml blood sample was collected from 78 consecutive mCRC patients before treatment with investigational and standard chemotherapeutics. The mRNA expression of EMT (PI3Ka, Akt-2, Twist1) and stem cell (ALDH1) markers was measured. Associations between CTC gene expression and progression-free survival (PFS) and overall survival (OS) were determined using Cox regression models. Among patients without CK20 or survivin-expressing CTCs (n = 17), 55% had expression of ALDH1, PI3Ka and/or Akt-2. Patients with positive CTC Akt-2 expression had a significantly shorter median PFS (3.0 versus 4.0 months) compared with those without CTC Akt-2 expression in univariable (hazard ratio (HR) = 1.61; log-rank P =0.034) and multivariable analyses (HR= 1.70; adjusted P =0.041). In univariable analysis, CTC ALDH1 expression was associated with shorter OS (10.0 versus 38.6 months; HR = 2.04, P =0.021). Patients with CTCs expressing ALDH1, PI3Ka and/or Akt-2 had a significantly inferior PFS (3.0 versus 7.7 months; HR= 1.88, P = 0.015) and OS (10.0 versus 26.8+ months; HR = 2.25, P = 0.050) in univariable, but not multivariable, analysis. Conclusions: CTC Akt-2 expression may serve as a clinically useful prognostic marker in mCRC patients and warrants further evaluation in prospective trials.
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影响因子: 50.5
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