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Observational Study
. 2019 Nov 8;19(1):1070.
doi: 10.1186/s12885-019-6158-3.

Less micrometastatic risk related to circulating tumor cells after endoscopic breast cancer surgery compared to open surgery

Shichao Li  1 , Wenting Yan  1 , Xinhua Yang  2 , Li Chen  1 , Linjun Fan  1 , Haoxi Liu  1 , Kun Liu  3 , Yi Zhang  4 , Jun Jiang  5
Affiliations
Observational Study

Less micrometastatic risk related to circulating tumor cells after endoscopic breast cancer surgery compared to open surgery

Shichao Li et al. BMC Cancer. .

Abstract

Background: Increase of circulating tumor cells (CTCs) has been found after surgery for various carcinomas but not confirmed for breast cancer, and whether endoscopic surgery confers identical effect to CTCs as open surgery did is not clear. The present study aimed to investigate whether CTCs increase after surgery and whether there is a difference between open surgery and endoscopic surgery.

Methods: Pre- and postoperative peripheral blood (5 mL) obtained from 110 female patients with operable breast cancer (53 underwent endoscopic surgery, 57 underwent open radical mastectomy). Quantitative real-time reverse transcription-PCR was done to detect cytokeratin 19 mRNA-positive CTC. CTC detection rate, cell number and the increase after surgery (named micrometastasis) were compared between the two groups.

Results: In the open group, CTC positive rate before and after surgery were 22.81 and 33.33%; median CTC number before and after surgery were 0.21 and 0.43 and 17 patients (29.82%) had increased micrometastatic risk. In the endoscopic group, CTC positive rate before and after surgery were 24.53 and 28.30%; median CTC number before and after surgery were 0.27 and 0.36, and 8 patients (15.09%) had increased micrometastatic risk. There was a suggestive higher postoperative CTC detection rate and CTC number and a significant increased postoperation micrometastatic risk was observed in the open group compared to the endoscopic group (OR = 3.19, 95%CI: 1.05-9.65) after adjustment for clinicopathologic characteristics.

Discussion: CTC tends to increase in breast cancer patients after surgery, and the micrometastatic risk was higher for open surgery compared to endoscopic surgery.

Trial registration: This study was prospectively registered at Chinese Clinical Trial Register (ChiCTR-OCH-10000859, 24 April 2010).

Keywords: Breast neoplasms; Circulating tumor cells; Endoscopic breast surgery; Micrometastases; Neoplastic cells; Open surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of CTC positive rate before and after breast cancer surgery: meta-analysis. The heterogeneity of the recruited studies was estimated by the Cochran’s Q test (P = 0.147) and the I2 (27.5%). P value < 0.10 or I2 over 50% was defined as substantial heterogeneity. Hence, no substantial heterogeneity was observed among the studies and fixed model was used to analyze the overall difference of CTC positive rate before and after breast cancer surgery therapy (OR = 1.21, 95% CI: 1.06–1.39; P = 0.006). OR over 1 indicates increased CTC positive rate after surgery compared to preoperation
See this image and copyright information in PMC

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