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European Archives of Oto-Rhino-Laryngology

11.05.2024 | Head and Neck

Circulating tumor cells: a valuable indicator for locally advanced nasopharyngeal carcinoma

verfasst von: Ting Liu, Jing Liu, Guimei Wang, Chunmei Chen, Lihe He, Rensheng Wang, Chunli Ouyang

Erschienen in: European Archives of Oto-Rhino-Laryngology

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Abstract

Background

Advancements in nasopharyngeal carcinoma (NPC) treatment have led to a focus on personalized treatment. Circulating tumor cells (CTCs) are important for liquid biopsies and personalized treatment but are not being fully utilized. This study examined how pre- and post-treatment CTC counts, EMT subtypes, clinical characteristics, and patient prognosis are related in order to support the use of liquid biopsy in managing NPC.

Methods

This retrospective study included 141 patients with locally advanced NPC. All patients underwent CanPatrol™ CTC detection pre- and post-treatment and were categorized into EMT subtypes: epithelial type, mixed type, and mesenchymal type. This study analyzed CTC enumeration, EMT subtypes, and their associations with clinical characteristics and survival outcomes.

Results

The results indicated a positive correlation between the pre-treatment detection rate of CTCs and N stage (P < 0.01), alongside a positive correlation with the TNM clinical stage (P = 0.02). Additionally, the detection rate of mesenchymal CTCs post-treatment is positively associated with the N stage (P = 0.02). The enumeration of CTCs pre- and post-treatment is negatively correlated with prognosis and has statistical significance. Additionally, an investigation into the EMT subtypes of CTCs revealed a significant association between the presence of mesenchymal CTCs pre- and post-treatment and decreased overall survival (OS) (P < 0.05). Furthermore, T stage, N stage, TNM clinical stage, and Epstein-Barr virus (EBV) DNA were also significantly correlated with OS.

Conclusion

The study found that mesenchymal CTCs pre- and post-treatment, as well as the number of CTCs, were linked to a poor prognosis.

Chen Y-P, Chan ATC, Le Q-T, Blanchard P, Sun Y, Ma J (2019) Nasopharyngeal carcinoma. The Lancet 394:64–80. https://doi.org/10.1016/s0140-6736(19)30956-0CrossRef

Chang ET, Ye W, Zeng Y-X, Adami H-O (2021) The evolving epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomark Prev 30:1035–1047. https://doi.org/10.1158/1055-9965.Epi-20-1702CrossRef

He T, Yan R-N, Chen H-Y, Zeng Y-Y, Xiang Z-Z, Liu F et al (2021) Comparing the 7th and 8th editions of UICC/AJCC staging system for nasopharyngeal carcinoma in the IMRT era. BMC Cancer. https://doi.org/10.1186/s12885-021-08036-8CrossRefPubMedPubMedCentral

Xia W-X, Zhang H-B, Shi J-L, Lu X, Wang L, Ye Y-F et al (2013) A prognostic model predicts the risk of distant metastasis and death for patients with nasopharyngeal carcinoma based on pre-treatment serum C-reactive protein and N-classification. Eur J Cancer 49:2152–2160. https://doi.org/10.1016/j.ejca.2013.03.003CrossRefPubMed

Pan JJ, Ng WT, Zong JF, Lee SWM, Choi HCW, Chan LLK et al (2016) Prognostic nomogram for refining the prognostication of the proposed 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 122:3307–3315. https://doi.org/10.1002/cncr.30198CrossRefPubMed

Bossi P, Chan AT, Licitra L, Trama A, Orlandi E, Hui EP et al (2021) Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol 32:452–465. https://doi.org/10.1016/j.annonc.2020.12.007CrossRefPubMed

Tang LL, Chen YP, Chen CB, Chen MY, Chen NY, Chen XZ et al (2021) The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma. Cancer Commun 41:1195–1227. https://doi.org/10.1002/cac2.12218CrossRef

Chen Y-P, Liu X, Zhou Q, Yang K-Y, Jin F, Zhu X-D et al (2021) Metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma: a multicentre, open-label, parallel-group, randomised, controlled, phase 3 trial. The Lancet 398:303–313. https://doi.org/10.1016/s0140-6736(21)01123-5CrossRef

Zhang Y, Chen L, Hu G-Q, Zhang N, Zhu X-D, Yang K-Y et al (2019) Gemcitabine and cisplatin induction chemotherapy in nasopharyngeal carcinoma. N Engl J Med 381:1124–1135. https://doi.org/10.1056/NEJMoa1905287CrossRefPubMed

10.

Sun Y, Li W-F, Chen N-Y, Zhang N, Hu G-Q, Xie F-Y et al (2016) Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial. Lancet Oncol 17:1509–1520. https://doi.org/10.1016/s1470-2045(16)30410-7CrossRefPubMed

11.

Nikanjam M, Kato S, Kurzrock R (2022) Liquid biopsy: current technology and clinical applications. J Hematol Oncol. https://doi.org/10.1186/s13045-022-01351-yCrossRefPubMedPubMedCentral

12.

Alix-Panabières C, Pantel K (2021) Liquid biopsy: from discovery to clinical application. Cancer Discov 11:858–873. https://doi.org/10.1158/2159-8290.Cd-20-1311CrossRefPubMed

13.

Vasseur A, Kiavue N, Bidard FC, Pierga JY, Cabel L (2020) Clinical utility of circulating tumor cells: an update. Mol Oncol 15:1647–1666. https://doi.org/10.1002/1878-0261.12869CrossRefPubMedPubMedCentral

14.

Galvis MM, Romero CS, Bueno TO, and Teng Y (2021) Toward a new era for the management of circulating tumor cells, reviews on new drug targets in age-related disorders. pp 125–134

15.

Lowes LE and Allan AL (2018) Circulating tumor cells and implications of the epithelial-to-mesenchymal transition. pp 121–181

16.

Friendlander AH, Ettinger RL (2009) Karnofsky performance status scale. Spec Care Dentist 29:147–148. https://doi.org/10.1111/j.1754-4505.2009.00088.xCrossRefPubMed

17.

Wu J, Zhu H, Gao F, Wang R, Hu K (2021) Circulating Tumor Cells: a promising biomarker in the management of nasopharyngeal carcinoma. Front Oncol. https://doi.org/10.3389/fonc.2021.724150CrossRefPubMedPubMedCentral

18.

He Q, Zhou Y, Zhou J, Zhao D, Li L, Li X et al (2023) Clinical relevance of plasma EBV DNA as a biomarker for nasopharyngeal carcinoma in non-endemic areas: a multicenter study in southwestern China. Clin Chim Acta. https://doi.org/10.1016/j.cca.2023.117244CrossRefPubMed

19.

Siak PY, Khoo AS-B, Leong CO, Hoh B-P, Cheah S-C (2021) Current status and future perspectives about molecular biomarkers of nasopharyngeal carcinoma. Cancers. https://doi.org/10.3390/cancers13143490CrossRefPubMedPubMedCentral

20.

Tan R, Phua SKA, Soong YL, Oon LLE, Chan KS, Lucky SS et al (2020) Clinical utility of Epstein-Barr virus DNA and other liquid biopsy markers in nasopharyngeal carcinoma. Cancer Commun 40:564–585. https://doi.org/10.1002/cac2.12100CrossRef

21.

Yang W-Y, Feng L-F, Meng X, Chen R, Xu W-H, Hou J et al (2020) Liquid biopsy in head and neck squamous cell carcinoma: circulating tumor cells, circulating tumor DNA, and exosomes. Expert Rev Mol Diagn 20:1213–1227. https://doi.org/10.1080/14737159.2020.1855977CrossRefPubMed

22.

Wen Z, Li Z, Yong P, Liang D, Xie D, Chen H et al (2019) Detection and clinical significance of circulating tumor cells in patients with nasopharyngeal carcinoma. Oncol Lett. https://doi.org/10.3892/ol.2019.10560CrossRefPubMedPubMedCentral

23.

Xie X-Q, Luo Y, Ma XL, Li S-S, Liu L, Zhang H, Li P, Wang F (2019) Clinical significance of circulating tumor cells and their expression of cyclooxygenase-2 in patients with nasopharyngeal carcinoma. Eur Rev Med Pharmacol Sci. https://doi.org/10.26355/eurrev_201908_18735CrossRefPubMed

24.

Dongre A, Weinberg RA (2018) New insights into the mechanisms of epithelial–mesenchymal transition and implications for cancer. Nat Rev Mol Cell Biol 20:69–84. https://doi.org/10.1038/s41580-018-0080-4CrossRef

25.

Huang RY-J, Guilford P, Thiery JP (2012) Early events in cell adhesion and polarity during epithelial-mesenchymal transition. J Cell Sci 125:4417–4422. https://doi.org/10.1242/jcs.099697CrossRefPubMed

26.

Brabletz T, Jung A, Reu S, Porzner M, Hlubek F, Kunz-Schughart LA et al (2001) Variable beta-catenin expression in colorectal cancers indicates tumor progression driven by the tumor environment. Proc Natl Acad Sci U S A 98(18):10356–10361. https://doi.org/10.1073/pnas.171610498CrossRefPubMedPubMedCentral

27.

Beerling E, Seinstra D, de Wit E, Kester L, van der Velden D, Maynard C et al (2016) Plasticity between epithelial and mesenchymal states unlinks EMT from metastasis-enhancing stem cell capacity. Cell Rep 14:2281–2288. https://doi.org/10.1016/j.celrep.2016.02.034CrossRefPubMedPubMedCentral

28.

Ou G, Xing S, Li J, Zhang L, Chen S (2019) Circulating tumor cells: a valuable marker of poor prognosis for advanced nasopharyngeal carcinoma. Mol Med. https://doi.org/10.1186/s10020-019-0112-3CrossRefPubMedPubMedCentral

29.

Qian Y, Wu Y, Yuan Z, Niu X, He Y, Peng J et al (2019) The frequency of circulating tumour cells and the correlation with the clinical response to standard chemoradiotherapy in locally advanced nasopharyngeal carcinoma: a prospective study. Cancer Manage Res 11:10187–10193. https://doi.org/10.2147/cmar.S222916CrossRef

30.

Gao T, Mao J, Huang J, Luo F, Lin L, Lian Y et al (2023) Prognostic significance of circulating tumor cell measurement in the peripheral blood of patients with nasopharyngeal carcinoma. Clinics. https://doi.org/10.1016/j.clinsp.2023.100179CrossRefPubMedPubMedCentral

31.

Shibue T, Weinberg RA (2017) EMT, CSCs, and drug resistance: the mechanistic link and clinical implications. Nat Rev Clin Oncol 14:611–629. https://doi.org/10.1038/nrclinonc.2017.44CrossRefPubMedPubMedCentral

32.

Byers LA, Diao L, Wang J, Saintigny P, Girard L, Peyton M et al (2013) An epithelial-mesenchymal transition gene signature predicts resistance to EGFR and PI3K inhibitors and identifies Axl as a therapeutic target for overcoming EGFR inhibitor resistance. Clin Cancer Res 19:279–290. https://doi.org/10.1158/1078-0432.Ccr-12-1558CrossRefPubMed

33.

Mittal V (2018) Epithelial mesenchymal transition in tumor metastasis. Annu Rev Pathol 13:395–412. https://doi.org/10.1146/annurev-pathol-020117-043854CrossRefPubMed

34.

Tsao SW, Tsang CM, Lo KW (2017) Epstein-Barr virus infection and nasopharyngeal carcinoma. Philos Trans R Soc B. https://doi.org/10.1098/rstb.2016.0270CrossRef

35.

Lee AWM, Lee VHF, Ng W-T, Strojan P, Saba NF, Rinaldo A et al (2021) A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma. Eur J Cancer 153:109–122. https://doi.org/10.1016/j.ejca.2021.05.022CrossRefPubMed

36.

Trevisiol C, Gion M, Vaona A, Fabricio ASC, Roca E, Licitra L et al (2021) The appropriate use of circulating EBV-DNA in nasopharyngeal carcinoma: comprehensive clinical practice guidelines evaluation. Oral Oncol. https://doi.org/10.1016/j.oraloncology.2020.105128CrossRefPubMed

37.

Hsu C-L, Chan S-C, Chang K-P, Lin T-L, Lin C-Y, Hsieh C-H et al (2013) Clinical scenario of EBV DNA follow-up in patients of treated localized nasopharyngeal carcinoma. Oral Oncol 49:620–625. https://doi.org/10.1016/j.oraloncology.2013.02.006CrossRefPubMed

38.

Yap K, Cohen EN, Reuben JM, Khoury JD (2019) Circulating Tumor Cells: state-of-the-art update on technologies and clinical applications. Curr Hematol Malig Rep 14:353–357. https://doi.org/10.1007/s11899-019-00531-xCrossRefPubMed

39.

Yu Y, Lin Z-X, Li H-W, Luo H-Q, Yang D-H, Zhou H-C et al (2020) Circulating tumor cells and fibronectin 1 in the prognosis of nasopharyngeal carcinoma. Technol Cancer Res Treat. https://doi.org/10.1177/1533033820909911CrossRefPubMedPubMedCentral

40.

Li Y-J, Luo Y, Xie X-Q, Li P, Wang F (2018) The prognostic value of COX-2 expression on circulating tumor cells in nasopharyngeal carcinoma: a prospective analysis. Radiother Oncol 129:396–402. https://doi.org/10.1016/j.radonc.2018.07.022CrossRefPubMed

41.

Liu Z, Li L, Yang Z, Luo W, Li X, Yang H et al (2010) Increased expression of MMP9 is correlated with poor prognosis of nasopharyngeal carcinoma. BMC Cancer. https://doi.org/10.1186/1471-2407-10-270CrossRefPubMedPubMedCentral

Titel: Circulating tumor cells: a valuable indicator for locally advanced nasopharyngeal carcinoma
verfasst von: Ting Liu
Jing Liu
Guimei Wang
Chunmei Chen
Lihe He
Rensheng Wang
Chunli Ouyang
Publikationsdatum: 11.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08714-w

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Circulating tumor cells: a valuable indicator for locally advanced nasopharyngeal carcinoma

Abstract

Background

Methods

Results

Conclusion

Neu im Fachgebiet HNO

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Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

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Neu im Fachgebiet HNO

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

Update HNO