title: Circulating tumor cells in patients with solid malignancy treated by high-intensity focused ultrasound.
abstract: The theoretical possibility that exposure of a solid malignancy to high-intensity focused ultrasound (US), or HIFU, could lead to an increased rate of metastasis still remains. Using reverse transcriptase polymerase chain reaction (RT-PCR), the potential risk of hematogenous dissemination was assessed in HIFU-treated patients with solid malignancy. RT-PCR can demonstrate the presence or absence of specific RNA fragments. On the day before HIFU ablation, 5-mL peripheral blood samples were collected, and again 5 to 7 days after HIFU, from 26 enrolled patients (hepatocellular carcinoma, HCC: 10; osteosarcoma: 16). Total RNA was isolated and RT-PCR was performed to analyze the mRNA expression of (alpha-fetoprotein (AFP) and bone-specific alkaline phosphatase (BALP) genes. Positive AFP mRNA expression was preoperatively detected in 8 of 10 patients with HCC. In the postoperative specimens, positive expression was also detected in 8 of 10 patients. In 2 patients, circulating tumor cells were found preoperatively, but not postoperatively. Conversely, 2 patients with no circulating tumor cells preoperatively were found to have circulating tumor cells after HIFU. Of 16 osteosarcoma patients, 12 patients had circulating tumor cells and 4 had none. After HIFU treatment, 2 of the 12 patients had converted from presence to absence of circulating cells and the remaining 4 patients remained negative. It is concluded that patients undergoing complete HIFU ablation may demonstrate conversion from presence to absence of circulating tumor-specific marker mRNA, and that HIFU would not enhance the potential risk of metastasis in patients with malignant diseases.
authors.affiliation: Clinical Center for Tumor Therapy of 2nd Affiliated Hospital, and Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China. clinical@haifu.com.cn
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.forename: Zhi-Biao
authors.initials: ZB
authors.lastname: Wang
authors.forename: Cheng-Bing
authors.initials: CB
authors.lastname: Jin
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Zhang
authors.forename: Wen-Zhi
authors.initials: WZ
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Bai
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Zou
authors.forename: Hui
authors.initials: H
authors.lastname: Zhu
mesh_terms: D000469:Alkaline Phosphatase / Q000235:genetics; D001859:Bone Neoplasms / Q000097:blood / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000628:therapy; D045744:Cell Line, Tumor; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000628:therapy; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D009360:Neoplastic Cells, Circulating; D012516:Osteosarcoma / Q000097:blood / Q000628:therapy; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D014464:Ultrasonic Therapy / Q000009:adverse effects*; D000509:alpha-Fetoproteins / Q000235:genetics
chemical_list: D012333:RNA, Messenger; D012334:RNA, Neoplasm; D000509:alpha-Fetoproteins; D000469:Alkaline Phosphatase