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An improved strategy to detect the epithelial-mesenchymal transition process in circulating tumor cells in hepatocellular carcinoma patients

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Abstract

Purpose

We adopted a new strategy to explore the relationship between the EMT process of CTCs and hepatocellular carcinoma (HCC). Furthermore, we intend to illustrate the potential diagnostic value of CTCs of distinct phenotypes in HCC.

Methods

The clinical data of 33 HCC patients and 10 healthy volunteers were collected retrospectively. By using the optimized CanPatrol CTC enrichment technique, patient blood samples of about 5 ml were collected, and CTCs were identified and characterized. The first step of this detection process was to isolate CTCs via a filter-based method; then, an RNA in situ hybridization (RNA-ISH) technique based on the branched DNA signal amplification technology was used to classify the CTCs according to EMT markers. The relationships between HCC CTCs and clinical characteristics were analyzed.

Results

The number of epithelial CTCs was related to tumor size (r = 0.456, p = 0.008), epithelial-mesenchymal-mixed CTCs were related to tumor number (r = 0.421, p = 0.015), and mesenchymal CTC was associated with metastasis (r = 0.375, p = 0.032). There was no significant correlation between CTC number and other clinicopathological factors, such as age, serum AFP level or cirrhosis.

Conclusions

Epithelial-mesenchymal-mixed CTCs seem to play an important role in EMT transition in HCC, mixed CTCs might be a vital factor for intrahepatic metastasis, and mesenchymal CTCs had the potential to be a predictor of extrahepatic metastasis.

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Author notes

    Authors and Affiliations

    1. Department of Interventional Radiology, Cancer Center, Guangdong General Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

      Yong-kang Liu & Li-gong Lu

    2. Department of Interventional Radiology, Cancer Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China

      Bao-shan Hu & Zhong-liang Li

    3. Department of Interventional Radiology, Cancer Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China

      Xu He & Yong Li

    Authors
    1. Yong-kang Liu
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    2. Bao-shan Hu
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    3. Zhong-liang Li
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    4. Xu He
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    5. Yong Li
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    Correspondence to Li-gong Lu.

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    Conflict of interest

    Written informed consent was obtained from each patient and volunteer, and the final protocol was approved by the independent ethics committee of Guangdong General Hospital & Guangdong Academy of Medical Sciences. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Li-gong Lu, Yong-kang Liu, Bao-shan Hu, Zhong-liang Li, Xu He and Yong Li declare that they have no conflict of interest.

    Additional information

    Yong-kang Liu, Bao-shan Hu and Zhong-liang Li have contributed equally to this work.

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    Liu, Yk., Hu, Bs., Li, Zl. et al. An improved strategy to detect the epithelial-mesenchymal transition process in circulating tumor cells in hepatocellular carcinoma patients. Hepatol Int 10, 640–646 (2016). https://doi.org/10.1007/s12072-016-9732-7

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    • DOI: https://doi.org/10.1007/s12072-016-9732-7

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