title: Stem cell-like circulating tumor cells indicate poor prognosis in gastric cancer.
abstract: Circulating tumor cells (CTCs), which have stem cell-like characteristics, might play a crucial role in cancer metastasis. CD44 has been identified as gastric cancer (GC) stem cell (CSC) marker. Here, the prognostic significance of CD44-positive CTCs in GC patients was investigated. CTCs were detected in 27 of 45 GC patients. The presence of CTCs was significantly associated with lymph node metastasis, distant metastasis, and recurrence (P = 0.007, P = 0.035, and P = 0.035, resp.). Nineteen of the 27 CTC-positive patients had CD44-positive CTCs. These patients were more likely to develop metastasis and recurrence than patients with CD44-negative CTCs. CD44-positive CTC counts were higher in recurrent patients than in the nonrecurrent ones (means 4.8 and 1.9, resp.; P = 0.010). Furthermore, 13 of 19 patients with CD44-positive CTCs developed recurrent disease, and the mean time to recurrence was shorter than that in patients with CD44-negative CTCs (10.54 ± 5.55 and 19.13 ± 9.72 months, resp.; P = 0.04). COX proportional hazards model indicated that the presence of CD44-positive CTCs and TNM stage were independent predictors of recurrence for GC (P = 0.030 and 0.008). So identifying the stem cell-like CTC subset may provide more clinically useful prognostic information than only detecting CTCs.
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Man
authors: M
authors: Li
authors: Tianjin Children Hospital, Tianjin 300074, China.
authors: Baogang
authors: B
authors: Zhang
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Zhiguang
authors: Z
authors: Zhang
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Xia
authors: X
authors: Liu
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Xiangjuan
authors: X
authors: Qi
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Jianqiu
authors: J
authors: Zhao
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Yong
authors: Y
authors: Jiang
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Haoyu
authors: H
authors: Zhai
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Yinglan
authors: Y
authors: Ji
authors: Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Dan
authors: D
authors: Luo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis; D009360:Neoplastic Cells, Circulating; D014411:Neoplastic Stem Cells; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor