title: Circulating Tumor Cell Count Correlates with Colorectal Neoplasm Progression and Is a Prognostic Marker for Distant Metastasis in Non-Metastatic Patients.
abstract: Enumeration of circulating tumor cells (CTCs) has been proven as a prognostic marker for metastatic colorectal cancer (m-CRC) patients. However, the currently available techniques for capturing and enumerating CTCs lack of required sensitivity to be applicable as a prognostic marker for non-metastatic patients as CTCs are even more rare. We have developed a microfluidic device utilizing antibody-conjugated non-fouling coating to eliminate nonspecific binding and to promote the multivalent binding of target cells. We then established the correlation of CTC counts and neoplasm progression through applying this platform to capture and enumerate CTCs in 2 mL of peripheral blood from healthy (n = 27), benign (n = 21), non-metastatic (n = 95), and m-CRC (n = 15) patients. The results showed that the CTC counts progressed from 0, 1, 5, to 36. Importantly, after 2-year follow-up on the non-metastatic CRC patients, we found that those who had ≥5 CTCs were 8 times more likely to develop distant metastasis within one year after curable surgery than those who had <5. In conclusion, by employing a sensitive device, CTC counts show good correlation with colorectal neoplasm, thus CTC may be as a simple, independent prognostic marker for the non-metastatic CRC patients who are at high risk of early recurrence.
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-Sy
authors.initials: WS
authors.lastname: Tsai
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jinn-Shiun
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Shao
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.
authors.forename: Jen-Chia
authors.initials: JC
authors.lastname: Wu
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.
authors.forename: Jr-Ming
authors.initials: JM
authors.lastname: Lai
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.|Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan.
authors.forename: Si-Hong
authors.initials: SH
authors.lastname: Lu
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.
authors.forename: Tsung-Fu
authors.initials: TF
authors.lastname: Hung
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.
authors.forename: Yen-Chi
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Jeng-Fu
authors.initials: JF
authors.lastname: You
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Pao-Shiu
authors.initials: PS
authors.lastname: Hsieh
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Chien-Yuh
authors.initials: CY
authors.lastname: Yeh
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Hsin-Yuan
authors.initials: HY
authors.lastname: Hung
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Sum-Fu
authors.initials: SF
authors.lastname: Chiang
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Geng-Ping
authors.initials: GP
authors.lastname: Lin
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, 5 Fu-Hsing St. Kueishan, Taoyuan, Taiwan.
authors.forename: Reiping
authors.initials: R
authors.lastname: Tang
authors.affiliation: Genomics Research Center, Academia Sinica, 128, Sec. 2, Academic Rd., Nankang, Taipei 115, Taiwan.|Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan.
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count / Q000295:instrumentation* / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D044085:Microfluidics / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D009360:Neoplastic Cells, Circulating; D011379:Prognosis