title: Evaluation of epithelial-mesenchymal transitioned circulating tumor cells in patients with resectable gastric cancer: Relevance to therapy response.
abstract: OBJECTIVE
  To evaluate the epithelial-to-mesenchymal transition (EMT) of circulating tumor cells (CTCs) in gastric cancer patients.
  
  
  METHODS
  We detected tumor cells for expression of four epithelial (E(+)) transcripts (keratins 8, 18, and 19 and epithelial cell adhesion molecule) and two mesenchymal (M(+)) transcripts (Vimentin and Twist) by a quantifiable, dual-colorimetric RNA-in situ hybridization assay. Between July 2014 and October 2014, 44 patients with gastric cancer were recruited for CTC evaluation. Blood samples were obtained from selected patients during the treatment course [before surgery, after surgery and at the 6(th) cycle of XELOX based chemotherapy (about 6 mo postoperatively)].
  
  
  RESULTS
  We found the EMT phenomenon in which there were a few biphenotypic E(+)/M(+) cells in primary human gastric cancer specimens. Of the 44 patients, the presence of CTCs was reported in 35 (79.5%) patients at baseline. Five types of cells including from exclusively E(+) CTCs to intermediate CTCs and exclusively M(+) CTCs were identified (4 patients with M(+) CTCs and 10 patients with M(+) or M(+) > E(+) CTCs). Further, a chemotherapy patient having progressive disease showed a proportional increase of mesenchymal CTCs in the post-treatment blood specimens. We used NCI-N87 cells to analyze the linearity and sensitivity of CanPatrol(TM) system and the correlation coefficient (R(2)) was 0.999.
  
  
  CONCLUSIONS
  The findings suggest that the EMT phenomenon was both in a few cells of primary tumors and abundantly in CTCs from the blood of gastric cancer patients, which might be used to monitor therapy response.
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Li
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Feng-Ping
authors.initials: FP
authors.lastname: Li
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Yan-Feng
authors.initials: YF
authors.lastname: Hu
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Mou
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Lin
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yu
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Ting-Ting Li, Hao Liu, Feng-Ping Li, Yan-Feng Hu, Ting-Yu Mou, Tian Lin, Jiang Yu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Guo-Xin
authors.initials: GX
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics; D000069287:Capecitabine; D016022:Case-Control Studies; D045744:Cell Line, Tumor; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D005743:Gastrectomy; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism / Q000473:pathology*; D010071:Oxaloacetates; D010641:Phenotype; D013274:Stomach Neoplasms / Q000097:blood / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil
keywords: Chemotherapy; Circulating tumor cells; Epithelial-to-mesenchymal transition; Gastric cancer; Therapy response