The clinical significance of circulating tumor cells and T lymphocyte subtypes in pancreatic cancer patients

Figures & data

Figure 1. EMT phenotypes of CTCs were detected by the RNA in situ hybridization in pancreatic cancer patients. A: Fluorescence microscopy images show three types of CTCs with positive expression of epithelial markers (EpCAM and CK8/18/19, red dots); B, mesenchymal markers (Vimentin and Twist, green dots); C, DAPI stained nuclear; D, biphenotypic markers; Pictures were taken in immunofluorescence microscope by 40x magnification. CTC, circulating tumor cells; DAPI, 4′,6-diamidino-2-phenylindole (DAPI).

Table 1. Relationship between the presence of circulating tumor cells (CTCs) and the clinical features of pancreatic carcinoma

	Number of Cases	CTC-positive(%)	CTC-negative (%)	χ2	P values
Age
≤ 60 year-old	33 (31.1%)	23 (69.7%)	10 (30.3%)	4.99	0.03
>60 year-old	73 (68.9%)	64 (87.7%)	9 (12.3%)
Gender
Female	44 (41.5%)	32 (72.7%)	12 (27.3%)	0.92	0.34
Male	62 (58.5%)	50 (80.6%)	12 (19.4%)
Pathological Stage
II	32 (30.2%)	12 (37.5%)	20 (62.5%)	36.96	0.0001
III	50 (47.2%)	44 (88.0%)	6 (12.0%)
IV	24 (22.6%)	24 (100.0%)	0 (0.0%)

Table 2. Comparison of PFS in different CTC cell number

Variables	PFS in >6 CTC (months)	PFS in ≤6 CTC (months)	HR	% 95 CI	P value
Total CTC	5	9	2.96	1.13 to 7.75	0.0001
eCTC	4	8	1.70	0.38 to 7.5	0.12
MixedCTC	5	9	5.31	1.71to16.45	0.0001
MCTC	4	8	4.14	0.44 to 39	0.01

PFS, progression-free survival; CTC, circulating tumor cell; eCTC, epithelial circulating tumor cell; MCTC, mesenchymal circulating tumor cell.HR, hazard ratio; CI, confidence interval.

Figure 2. Kaplan–Meier curves for progression-free survival (PFS) of patients according to CTC, epithelial CTCs, mixed CTCs, and mesenchymal CTC (MCTC). (a) total CTC; (b) epithelial CTCs; (c, d) Mixed MCTC and MCTC with PFS. CTC, circulating tumor cells; PFS, progression-free survival; MCTC, mesenchyaml CTC.

Table 3. Association between PDAC and different subtypes of T lymphocyte (mean ± SD)

Variables (%)	Control (n = 10)	StageII (n = 32)	Stage III (n = 50)	Stage IV (n = 24)	F value	P value
CD3	76.67 ± 5.16	60.07 ± 10.26	55.06 ± 13.15	53.2 ± 7.82	10.83	0.0001
CD4	42.47 ± 4.89	30.18 ± 7.36	22.68 ± 7.53	20.05 ± 4.88	13.31	0.0001
CD8	25.37 ± 2.92	23.59 ± 5.88	23.36 ± 7.18	18.75 ± 3.51	6.97	0.13
CD4/8	1.66 ± 0.24	1.31 ± 0.31	1.07 ± 0.53	1.07 ± 0.20	5.27	0.003
NK cells	20.05 ± 2.90	15.47 ± 3.5	14.76 ± 3.27	13.31 ± 2.84	7.15	0.0004
Treg cells	5.1 ± 1.37	9.4 ± 2.86	9.72 ± 2.72	9.1 ± 2.12	7.89	0.0003

PDAC, pancreatic ductal adenocarcinoma; NK, natural killer; T reg, T regulatory lymphocyte.

Table 4. Association between PDAC and cytokines (mean ± SD)

Variables (%)	Control (n = 10)	StageII (n = 32)	Stage III (n = 50)	Stage IV (n = 24)	F value	P value
IL-2	16.35 ± 4.15	10.09 ± 1.47	9.71 ± 5.66	8.19 ± 3.63	6.46	0.001
IL-4	10.69 ± 5.82	7.77 ± 3.01	8.36 ± 4.01	7.68 ± 2.59	1.073	0.37
IL-17A	7.56 ± 2.85	9.27 ± 3.59	7.17 ± 2.77	7.8 ± 3.30	0.96	0.42
IL-10	23.88 ± 4.64	30.41 ± 3.84	30.24 ± 3.06	36.55 ± 6.39	10.56	0.0001
IFN-γ	8.73 ± 1.75	4.69 ± 1.64	4.74 ± 1.68	1.46 ± 1.05	29.30	0.0001

IL-2, interleukin-2; IL-4, interleukin-4; IL-17A, interleukin-17A; IL-10, interleukin-10; IFN-γ, interferon γ.