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ER+ patients had the highest CTC counts (range: 0 30, median:8), while lower CTC counts were seen in HER2+ patients (range: 0 7, median:1) and in triple negative patients (range: 0 6, median:1) (Figure 5B).
The highest CTC positivity rate was obtained in triple-negative patients followed by those with ER-positive and/or PR-positive tumors (30% vs. 13%, P = 0.01).
Accordingly, in our study the highest CTC load in peripheral blood was noted immediately after surgery, to quickly decrease by the first postoperative day.
The mean CTC number at the time of highest CTC value was 64 (SEM ± 30.6) compared to 2.4 (SEM ± 0.5) for the remaining CTC positive samples (P = 0.0001).
Patient #2 with 80% of the nondormant CTC population expressing Ki67 at the time of the highest CTC count relapsed 1.5 years later.
The authors observed that the highest CTC positivity rate was obtained in triple-negative patients followed by those with estrogen receptor (ER -positive and/or progER -positiveeptor (PR)-positive tumors, while no CTCs could be detected in the humand/ordermal growth factor receprogesterone)-positive subtype greceptor
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This might contribute to the apparent association between high postoperative CTC levels and poor prognosis, as high CTC levels could signify more systemically advanced disease.
By comparing the average CK intensity of the enriched CTCs, the enrichment with the combination antibodies (anti-CK and anti-EpCAM) showed not only a higher CTC count, but also detected more CTCs with relatively low CK expression levels).
In contrast, six patients had higher CTC counts using CellSearch than by ISET, while three patients had CTC counts higher using ISET than by CellSearch.
In the spike-in recovery study of 20 samples, recovery rate was never greater than 100% (unlike some other CTC platforms), and in the single-digit spike-in experiments, only one sample had a higher CTC count than spike-in number, and these cells could be morphologically distinguished as non-malignant.
Similar high CTC positivity detected by SE-iFISH® walsolsobserveded on lung (92 %) and esophageal (87%%) carcinoma patients [7].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com