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. 2025 Jul 1;25(1):1025.
doi: 10.1186/s12885-025-14178-w.

Preoperative circulating tumor cells indicate microvascular invasion and dynamical detection indicate the early recurrence of hepatocellular carcinoma

Xiaozhun Huang #  1 , Haoxiang Wen #  1 , Yan Huang #  2 , Wenyan Kang  3 , Zhenyu Lin  1 , Lin Xu  1 , Yihong Ran  1 , Zhangkan Huang  1 , Dong Chen  1 , Heng Zou  2 , Xinyu Bi  4 , Xu Che  5
Affiliations

Preoperative circulating tumor cells indicate microvascular invasion and dynamical detection indicate the early recurrence of hepatocellular carcinoma

Xiaozhun Huang et al. BMC Cancer. .

Abstract

Background: This study aimed to investigate the relationship between preoperative circulating tumor cells (CTCs) and microvascular invasion (MVI), and the relationship between dynamic changes of CTCs and early recurrence in hepatocellular carcinoma (HCC).

Methods: We enrolled 90 HCC patients who underwent hepatectomy and collected CTCs at 5 days before surgery and 1 month after surgery. They were divided into two groups according to the number of preoperative CTCs (CTCs ≤ 5/5 ml group, n = 29 and CTCs > 5/5 ml group, n = 61).

Results: Multivariate analysis showed that CTCs > 5/5 ml was independently associated with MVI (OR:3.227, P = 0.025). Compared with patients with postoperative CTC count increased, postoperative CTCs reduction was associated with better recurrence-free survival (RFS) (P = 0.021; 2-year RFS rate: 42.50% vs. 67.80%). The RFS of MVI negative patients was significantly longer than that of MVI positive patients (P = 0.013; 2-year RFS rate: 75.00% vs. 39.50%).

Conclusions: Preoperative CTC count in peripheral blood of HCC patients was closely related to MVI. The increased number of CTCs after surgery indicated a higher risk of early recurrence.

Keywords: Circulating tumor cells (CTCs); Hepatocellular carcinoma (HCC); Microvascular invasion (MVI); Recurrence.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study process was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Approval number: KYLX2021-38), and all participants have signed informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the patients included in this study. HCC: hepatocellular carcinoma; CTC: circulating tumor cell
Fig. 2
Fig. 2
Flow chart of the isolation and detection of CTCs. HCC: hepatocellular carcinoma; PBMC: peripheral blood mononuclear cell; CTC: circulating tumor cell
Fig. 3
Fig. 3
Representative immunofluorescence staining image of CTCs. Epithelial CTCs: DAPI+, CD45−, EpCAM/Pan-CK+, N-cadherin−; Mesenchymal CTCs: DAPI+, CD45−, EpCAM/Pan-CK−, N-cadherin+; Mixed-type CTCs: DAPI+, CD45−, EpCAM/Pan-CK+, N-cadherin+. The white arrows indicate the CTCs. CTC: circulating tumor cell
Fig. 4
Fig. 4
Kaplan-Meier survival curves comparing RFS and OS in the postoperative CTC and MVI groups. (A) RFS, postoperative CTC count decreased group vs. postoperative CTC count increased group; (B) RFS, MVI(-) group vs. MVI(+) group; (C) OS, postoperative CTC count decreased group vs. postoperative CTC count increased group; (D) OS, MVI(-) group vs. MVI(+) group. RFS: recurrence-free survival; OS.overall survival; CTC: circulating tumor cell; MVI: microvascular invasion
See this image and copyright information in PMC

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