Highly Correlated Recurrence Prognosis in Patients with Metastatic Colorectal Cancer by Synergistic Consideration of Circulating Tumor Cells/Microemboli and Tumor Markers CEA/CA19-9
Hsueh-Yao Chu,
Chih-Yung Yang,
Ping-Hao Yeh,
Chun-Jieh Hsu,
Lu-Wei Chang,
Wei-Jen Chan,
Chien-Ping Lin,
You-You Lyu,
Wei-Cheng Wu,
Chun-Wei Lee,
Jen-Kuei Wu,
Jeng-Kai Jiang,
Fan-Gang Tseng
Affiliations
Hsueh-Yao Chu
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Chih-Yung Yang
Department Education Research, Taipei City Hospital, Taipei 10341, Taiwan
Ping-Hao Yeh
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Chun-Jieh Hsu
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Lu-Wei Chang
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Wei-Jen Chan
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Chien-Ping Lin
Institute of Microbiology and Immunology, National Yang-Ming Chiao-Tung University, Taipei 11221, Taiwan
You-You Lyu
Institute of Microbiology and Immunology, National Yang-Ming Chiao-Tung University, Taipei 11221, Taiwan
Wei-Cheng Wu
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Chun-Wei Lee
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Jen-Kuei Wu
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Jeng-Kai Jiang
Department of Surgery, Division of Colorectal Surgery, Taipei Veterans General Hospital, Taiwan School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 11217, Taiwan
Fan-Gang Tseng
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
Circulation tumor cells (CTCs) play an important role in metastasis and highly correlate with cancer progression; thus, CTCs could be considered as a powerful diagnosis tool. Our previous studies showed that the number of CTCs could be utilized for recurrence prediction in colorectal cancer (CRC); however, the odds ratio was still lower than five. To improve prognosis in CRC patients, we analyzed CTC clusters/microemboli, CTC numbers, and carcinoembryonic antigen (CEA)/carbohydrate antigen 19-9 (CA19-9) levels using a self-assembled cell array (SACA) chip system for recurrence prediction. In CRC patients, the presence of CTC clusters/microemboli may have higher correlation in metastasis when compared to the high number of CTCs. Additionally, when both the number of CTCs and serum CEA levels are high, very high odds ratios of 24.4 and 17.1 are observed in patients at all stages and stage III of CRC, respectively. The high number of CTCs and CTC clusters/microemboli simultaneously suggests the high chance of relapse (odds ratio 8.4). Overall, the characteristic of CTC clusters/microemboli, CEA level, and CTC number have a clinical potential to enhance CRC prognosis.
