Early dynamic changes in circulating tumor cells and prognostic relevance following interventional radiological treatments in patients with hepatocellular carcinoma

The aim of this study was to investigate the dynamic changes of circulating tumor cells (CTCs) in patients with hepatocellular carcinoma (HCC) before and immediately after conducting a microwave ablation (MWA) and conventional transarterial chemoembolization (C-TACE). Additionally, the CTCs short-te...

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Published in:	PloS one Vol. 16; no. 2; p. e0246527
Main Authors:	Vogl, Thomas J, Riegelbauer, Linda J, Oppermann, Elsie, Kostantin, Michel, Ackermann, Hanns, Trzmiel, Annette, Stein, Stefan, Eichler, Katrin, Zharov, Vladimir P, Roy, Dhruvajyoti, Schnitzbauer, Andreas A, Strücker, Benjamin, Pascher, Andreas, Bechstein, Wolf O, Juratli, Mazen A
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 12-02-2021 Public Library of Science (PLoS)
Subjects:	Antibodies Biology and Life Sciences Blood Blood cells Cancer therapies Care and treatment Catheters Cell adhesion & migration Chemotherapy Cloning Computer programs Data analysis Diagnosis Diagnostic systems Editing Embolization Flow cytometry Hepatocellular carcinoma Hepatoma Hospitals Immunofluorescence Liver cancer Medical instruments Medical prognosis Medicine and Health Sciences Methodology Nanotechnology Patient outcomes Patients Peripheral blood Physical Sciences Physiological aspects Prognosis Radiology Radiotherapy Research and Analysis Methods Software Staining Statistical analysis Surgery Tumor cells Tumor markers Tumors Visualization Germany United States > US Arkansas
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Summary:	The aim of this study was to investigate the dynamic changes of circulating tumor cells (CTCs) in patients with hepatocellular carcinoma (HCC) before and immediately after conducting a microwave ablation (MWA) and conventional transarterial chemoembolization (C-TACE). Additionally, the CTCs short-term dynamics were compared with the clinical course of the HCC-patients. Blood samples from 17 patients with HCC who underwent MWA (n = 10) or C-TACE (n = 7) were analyzed. Venous blood was taken before and immediately after the radiological interventions to isolate and quantify CTCs using flow cytometry. CTCs were identified as CD45- and positive for the markers ASGPR, CD146 and CD274 (PD-L1). Patients were followed of up to 2.2 years after the radiological intervention. CTCs were detected in 13 HCC patients (76%) prior to the radiological interventions. The rate of CTCs was significantly decreased after the intervention in patients treated with MWA (0.4 CTCs/mL of blood, p = 0.031). However, no significant differences were observed in patients who received C-TACE (0.3 CTCs/mL of blood, p = 0.300). Overall, no correlation was found between the CTCs rate before and after the radiological intervention and recurrence rate of HCC. This preliminary data could confirm the tumoricidal effects of MWA in patients with HCC by significantly decreasing CTCs rate. In our study, we were able to detect CTCs in HCC patients using 3 different tumor markers. This preliminary data shows significant lower CTCs detected in response to MWA. However, large-scale randomized clinical trials are needed to determine the future role and the prognostic relevance of CTCs following this treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have read the journal’s policy and have the following competing interests: VPZ is the co-founder of CytoAstra, LLC and DR is an employee of Laboratory for Advanced Medicine, Inc. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0246527