PMID- 35070429
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240405
IS  - 2078-6891 (Print)
IS  - 2219-679X (Electronic)
IS  - 2078-6891 (Linking)
VI  - 12
IP  - 6
DP  - 2021 Dec
TI  - Significance of circulating tumor cells in the portal vein regarding metastases 
      and vascular invasion in hepatocellular carcinoma patients.
PG  - 3050-3060
LID - 10.21037/jgo-21-734 [doi]
AB  - BACKGROUND: Vascular invasion is an important risk factor of poor prognosis in 
      hepatocellular carcinoma (HCC) patients. The detection of circulating tumor cells 
      (CTCs) in the blood is direct evidence of tumor presence. There are few reports 
      on CTCs and metastasis and vascular invasion of HCC. The purpose of this study 
      was to analyze the significance of CTCs in the portal vein regarding metastases 
      and vascular invasion in HCC patients. METHODS: A total of 104 HCC patients 
      diagnosed and treated in Zhengzhou University People's Hospital were enrolled. 
      Surgery was performed in 60 individuals. Portal vein blood samples were collected 
      before treatment for CTCs detection. We used the isolation by size of epithelial 
      tumor cells (ISET) and fluorescence in situ hybridization (FISH) to enrich and 
      classify CTCs from blood samples. The patients were divided into metastasis and 
      nonmetastasis groups according to the metastasis status before treatment. 
      Differences in clinical indicators such as alpha-fetoprotein (AFP) levels, tumor 
      size, CTCs count, and macrovascular tumor thrombus between the two groups were 
      analyzed as well as the associations of CTCs count with the above indicators. For 
      individuals with postoperative pathology, the relationship between CTCs counts 
      and microvascular invasion (MVI) was analyzed. RESULTS: The amounts of portal 
      vein CTCs were higher in patients with metastases compared with the nonmetastases 
      group (20 vs. 7; z=3.795; P<0.001). Multivariate logistic regression analysis 
      showed that the CTC count was a risk factor for HCC metastasis [odds ratio (OR) 
      =1.044; 95% CI: 1.011-1.079]. The sensitivity and specificity of CTC count in 
      predicting HCC metastasis were 82.93% and 52.38%, respectively. CTC count was 
      significantly correlated with tumor size (r(s)=0.308; P=0.001), vascular invasion 
      (z=4.211; P<0.001), and MVI (z=12.763; P=0.002). A threshold CTC count of seven 
      showed the most significant power for predicting metastasis. CONCLUSIONS: 
      Vascular invasion positivity was closely related to HCC metastasis. Portal vein 
      CTC count before treatment was correlated with vascular invasion and could be 
      considered one of the factors affecting HCC metastasis. However, the ability of 
      CTC count was limited in predicting HCC metastasis due to insufficient 
      specificity.
CI  - 2021 Journal of Gastrointestinal Oncology. All rights reserved.
FAU - Zhao, Xiaojuan
AU  - Zhao X
AD  - Department of Ultrasound, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
FAU - Zhao, Jingge
AU  - Zhao J
AD  - Clinical Research Center, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
FAU - Tao, Lianyuan
AU  - Tao L
AD  - Department of Hepatobiliary Surgery, Zhengzhou University People's Hospital, 
      Henan Provincial People's Hospital, Zhengzhou, China.
FAU - Pan, Yujin
AU  - Pan Y
AD  - Department of Hepatobiliary Surgery, Zhengzhou University People's Hospital, 
      Henan Provincial People's Hospital, Zhengzhou, China.
FAU - Yang, Long
AU  - Yang L
AD  - Department of Ultrasound, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
FAU - Zhang, Xijun
AU  - Zhang X
AD  - Department of Ultrasound, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
FAU - Yuan, Jianjun
AU  - Yuan J
AD  - Department of Ultrasound, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
FAU - Zhu, Haohui
AU  - Zhu H
AD  - Department of Ultrasound, Zhengzhou University People's Hospital, Henan 
      Provincial People's Hospital, Zhengzhou, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Gastrointest Oncol
JT  - Journal of gastrointestinal oncology
JID - 101557751
PMC - PMC8748049
OTO - NOTNLM
OT  - Portal vein
OT  - circulating tumor cell (CTC)
OT  - hepatocellular carcinoma (HCC)
OT  - metastasis
OT  - vascular invasion
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at https://dx.doi.org/10.21037/jgo-21-734). Xiaojuan Zhao reports 
      that this work was supported by the Henan Science and Technology Department (No. 
      202102310448). The other authors have no conflicts of interest to declare.
EDAT- 2022/01/25 06:00
MHDA- 2022/01/25 06:01
PMCR- 2021/12/01
CRDT- 2022/01/24 08:52
PHST- 2021/10/14 00:00 [received]
PHST- 2021/12/08 00:00 [accepted]
PHST- 2022/01/24 08:52 [entrez]
PHST- 2022/01/25 06:00 [pubmed]
PHST- 2022/01/25 06:01 [medline]
PHST- 2021/12/01 00:00 [pmc-release]
AID - jgo-12-06-3050 [pii]
AID - 10.21037/jgo-21-734 [doi]
PST - ppublish
SO  - J Gastrointest Oncol. 2021 Dec;12(6):3050-3060. doi: 10.21037/jgo-21-734.