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Comparative Study
. 2021 Jan 7:27:e926565.
doi: 10.12659/MSM.926565.

Comparison of CellSearch and Circulating Tumor Cells (CTC)-Biopsy Systems in Detecting Peripheral Blood Circulating Tumor Cells in Patients with Gastric Cancer

Dawei Ning  1 , Kai Cui  2 , Min Liu  2 , Yang Ou  3 , Zhendan Wang  4 , Benkui Zou  5 , Yangyang Shen  6 , Xinyang Lu  7 , Sheng Li  8 , Pang Li  9
Affiliations
Comparative Study

Comparison of CellSearch and Circulating Tumor Cells (CTC)-Biopsy Systems in Detecting Peripheral Blood Circulating Tumor Cells in Patients with Gastric Cancer

Dawei Ning et al. Med Sci Monit. .

Abstract

BACKGROUND The purpose of this study was to compare circulating tumor cells (CTCs)/circulating tumor microemboli (CTM) detection rates of the CellSearch and CTC-Biopsy systems in patients with gastric cancer (GC). We also investigated potential correlations between clinicopathological characteristics and prognosis in patients with GC. MATERIAL AND METHODS This prospective study was conducted at the Shandong Institute of Cancer Prevention and Control in China. Fifty-nine patients with GC and 22 healthy volunteers were recruited and their peripheral blood samples were examined by the CTC-Biopsy system and CellSearch system for CTC. RESULTS The rate of detection of CTCs/CTM was significantly higher with the CTC-Biopsy system than with the CellSearch system (59.32% vs. 27.12%, P<0.001). The Kappa value was 0.179, indicating poor consistency. CTCs detected with the CellSearch system in patients with stage III/IV GC was significantly correlated with neutrophil count (P=0.020), neutrophil/lymphocyte ratio (N/L ratio) (P=0.009), CA19-9 (P=0.049), tumor size (P=0.026), and the extent of vascular invasion (P=0.007). CTCs detected with the CTC-Biopsy system correlated with tumor differentiation (P=0.010). CTM in patients with stage I/II GC and stage II/IV GC correlated with CEA (P=0.004) and tumor differentiation (P=0.030), respectively. A CTC count >3 detected with the CellSearch system, and not the CTC-Biopsy system, correlated with reduced progression-free survival and overall survival. CONCLUSIONS The CTC-Biopsy system was superior to the CellSearch system for detecting CTCs in GC patients. CTM were detected with the CTC-Biopsy system but not with the CellSearch system. CTCs detected with the CellSearch system correlated with various clinicopathological factors and long-term survival outcomes.

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Conflict of interest statement

Conflict of interest

Among the authors listed in this paper, Li Sheng proposed the theory of circulating tumor cell detection and designed and verified the feasibility of the detection method. The CTC-Biopsy device was produced by Wuhan YZY Medical Technology Co, Ltd. YZY provided related equipment, testing supplies, and technical support. Li Sheng’s team carried out clinical trials and tests in Shandong Cancer Prevention and Control Institute. Li Sheng provided technical consulting services and academic promotion for the technical team of YZY. Li Sheng, Dawei Ning, Kai Cui, Min Liu, Yang Ou, Zhendan Wang, Benkui Zou, Yangyang Shen, Xinyang Lu, and Pang Li had no commercial interest in the CTC-Biopsy device. The terms of this arrangement have been reviewed and approved by the Shandong First Medical University and Shandong Academy of Medical Sciences in accordance with its policy on objectivity in research.

Figures

Figure 1
Figure 1
Circulating tumor cells (CTCs) were detected with the CellSearch system. In this system, CTCs were defined as circular or elliptical epithelial cells with specific cell surface antigen characteristics (EpCAM+/CK+/DAPI+/CD45−).
Figure 2
Figure 2
Circulating tumor cells (CTC)/circulating tumor microemboli (CTM) detected with the CTC-Biopsy system in patients with gastric cancer. Wright-Giemsa staining was performed for cytomorphological analysis. (A) CTC: nuclear-cytoplasmic ratio >0.8, irregular nuclear shape. (B) CTC: cell diameter >15 μm; abnormally large nucleoli. (C) CTC: thickened and wrinkled, with jagged nuclear membranes and side-shifted chromatin. (D) CTM: aggregation of tumor cells (≥3). All cells were analyzed under 40× magnification. Scale bar: 20 μm.
Figure 3
Figure 3
Correlation between circulating tumor cells (CTCs) detected with the CellSearch system and progression-free survival in 59 patients with gastric cancer (CTC ≤3 and CTC >3 group log-rank test, P<0.001).
Figure 4
Figure 4
Correlation between circulating tumor cells (CTCs) detected with the CellSearch system and overall survival in 59 patients with gastric cancer (CTC ≤03 and CTC >3 group log-rank test, P<0.001).
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