Circulating tumor cells as a potential biomarker for postoperative clinical outcome in HBV-related hepatocellular carcinoma

Abstract

Background

This study aimed to determine if the number of circulating tumor cells (CTCs) and changes in their numbers affected tumor recurrence and metastasis after surgical resection in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Methods

The primary endpoints were overall survival (OS) and progression-free survival (PFS). A total of 42 patients with HCC were selected from the First Affiliated Hospital of Guangxi Medical College from 2014 to 2017. CTCs were counted 1 day prior to and 30 days after surgical excision of HCC using the CanPatrol™ system.

Results

Numbers of CTCs (> 2 CTCs and > 5 CTCs per 5 ml peripheral blood) were significantly associated with Edmondson stage in HBV-related HCC prior to surgery (P = 0.004 and 0.014, respectively). However there were no significant associations between other tested clinicopathological factors and CTC counts. Postoperative CTC counts (> 2 and > 5) and pre/postoperative change in CTC counts were significantly associated with PFS (P = 0.02, 0.009, and 0.001, respectively), but not with OS. Receiver operating characteristic curve analysis showed that pre/postoperative changes in the CTC count were a better predictor of performance than absolute count. The postoperative CTC count was also significantly associated with positive TP53 expression (P < 0.05).

Conclusion

These results demonstrate that postoperative CTC counts (> 2 and > 5) and changes in CTC counts may be independent prognostic indicators for PFS in patients with HBV-related HCC, with the change in number of CTCs showing better predictive performance.

Keywords:

• circulating tumor cell
• hepatocellular carcinoma
• progression-free survival
• overall survival

Acknowledgments

The authors thank Prof Minhao Peng, Kaiyin Xiao, Ya Guo, and Xigang Chen for providing this study with HCC samples. The authors thank Associate Prof Bin Chen and Zhixiong Su for their invaluable help to my study. This work was supported in part by the National Nature Science Foundation of China (No: 81560535), 2018 Innovation Project of Guangxi Graduate Education (No: JGY2018037 and YCBZ2018036), 2017 Guangxi Medical University Training Program for Distinguished Young Scholars, the Nature Sciences Found of Guangxi province of China (No: 2013GXNSFAA019138), and 2014 Project by Open Foundation of Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research.

Disclosure

The authors report no conflicts of interest in this work.