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Endoscopy
DOI: 10.1055/a-2535-7440
Innovations and brief communications

Portal versus peripheral circulating tumor cells as prognostic biomarkers in patients with stage I–III pancreatic ductal adenocarcinoma

Thaninee Prasoppokakorn 
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Roongruedee Chaiteerakij
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
2   Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Faculty of Medicine, Chuallongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Areeya Buntho
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Praewphan Ingrungruanglert
3   Center of Excellence in Stem Cell and Cell Therapy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
4   Excellence Center for Stem Cell and Cell Therapy, King Chulalongkorn Memorial Hospital, Bangkok, Thailand (Ringgold ID: RIN176044)
,
Nipan Israsena
3   Center of Excellence in Stem Cell and Cell Therapy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
4   Excellence Center for Stem Cell and Cell Therapy, King Chulalongkorn Memorial Hospital, Bangkok, Thailand (Ringgold ID: RIN176044)
,
Wiriyaporn Rittitid
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
2   Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Faculty of Medicine, Chuallongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Phonthep Angsuwatcharakon 
5   Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Parit Mekaroonkamol
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Pradermchai Kongkam 
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
,
Rungsun Rerknimitr 
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
2   Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Faculty of Medicine, Chuallongkorn University, Bangkok, Thailand (Ringgold ID: RIN65103)
› InstitutsangabenGefördert durch: The Second Century Fund (C2F), Chulalongkorn University
Gefördert durch: Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology annual fund, Chulalongkorn University

Clinical Trial: Registration number (trial ID): TCTR20210202006, Trial registry: Thai Clinical Trials Registry (https://www.clinicaltrials.in.th/), Type of Study: Single-center prospective, interventional cohort study
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Abstract

Background

The detection of portal venous circulating tumor cells (CTCs) may better reflect vascular metastasis and predict micrometastasis risk than peripheral blood in patients with pancreatic ductal adenocarcinoma (PDAC). We hypothesize that portal CTCs could better represent micrometastasis and can predict survival in PDAC patients.

Methods

A single-center, prospective cohort study of patients with stage I–III PDAC was conducted. Portal venous blood was obtained via endoscopic ultrasound-guided sampling, and peripheral blood was collected on the same day. CTCs were detected using EpCAM and mucin1 antibodies and reported as cells/8 mL of blood.

Results

Among 35 patients, the portal and peripheral CTC detection rates were 94.3% and 82.9%, respectively. Advanced PDAC with locoregional metastasis had higher portal CTCs than less aggressive disease (P < 0.05), while peripheral CTCs showed no significant differences. During the 50-month follow-up, patients with portal CTCs ≥8 had poorer survival (6.1 vs. 19.0 months; P = 0.001) and patients with peripheral CTCs ≥3 also had poorer survival (4.6 vs. 14.2 months; P = 0.002). In multivariable analysis, both portal CTCs ≥8 and peripheral CTCs ≥3 showed significant adjusted associations with survival (adjusted hazard ratio 3.4 [P = 0.009] and 2.7 [P = 0.02], respectively).

Conclusion

Higher CTC counts in both the portal and peripheral systems were significantly associated with poorer survival in stage I–III PDAC; however, only portal CTCs reflected tumor aggression and locoregional metastasis.

Supplementary Material



Publikationsverlauf

Eingereicht: 26. August 2024

Angenommen nach Revision: 07. Februar 2025

Accepted Manuscript online:
07. Februar 2025

Artikel online veröffentlicht:
27. März 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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