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Of 27 patients with recurrent disease, 14 were positive for CTCs and 13 of the CTC-positive patients were also positive for CD44-positive CTCs.
Patients with CTC counts ≥5 CTCs/7.5 mL peripheral blood were defined as CTC-positive [ 11].
A change in CTC status was observed in 133 patients (42.6%); 64 patients (20.5%) with initially CK-19 mRNA-positive CTC during the first 24 months turned CTC-negative afterwards while 69 (22.1%) who were initially CTC-negative became CTC-positive.
Only CTC-positive patients were included in this analysis.
HER2-positive CTCs were identified in 55.6 % of early and 65.2 % of metastatic CTC-positive breast cancer patients.
Six patients had positive CTCs before and after treatment, 13 patients changed from CTC-positive to negative, 9 patients changed from CTC-negative to positive, and 43 patients remained CTC-negative.
In comparison, 53.4% of CTC-positive metastatic patients had exclusively dormant and 46.6% had proliferative CTCs; none had apoptotic CTCs (P = 0.039).
In 25 (62.5%) out of 40 CTC-positive patients, all detected CTCs were negative for both Ki67 and M30 (Ki67/M30 CTCs) corresponding to dormant cells [ 5, 30].
Interestingly, although ALDH1-expressing CTCs were identified in almost all CTC-positive patients, the pattern of ALDH1 expression differed among CTCs in both clinical settings.
We expected that 25% of patients would have CTC and a recurrence rate of 10% in the CTC-negative group and 20% in the CTC-positive group.
These patients were found to be CTC-positive when routinely screened for CK-positive/CD45-negative CTCs on PBMC smears.
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