title: Detection of circulating tumour cells may add value in endometrial cancer management.
abstract: OBJECTIVE
  To evaluate the role of circulating tumour cells (CTCs) in patients with endometrial cancer (EC).
  
  
  METHODS
  This study included 40 patients with a pre-operative diagnosis of high-risk EC between April 2015 and May 2016. Patients were further divided into high-risk (grade 3, non-endometrioid, myometrial invasion ≥1/2 and stage III-IV) and high-intermediate-risk (grade 2-3, endometrioid, myometrial invasion <1/2 and stage I-II) groups according to postoperative pathological results. CTCs were detected using the CellSearch system, and CTC results were correlated with standard clinicopathological characteristics and serum tumour marker CA125/HE4 status using Chi-squared test, continuity correction or Fisher's exact test. The pharmacodynamic effect was detected after the first cycle of adjuvant therapy. Patients were followed up for 13 months to assess outcomes.
  
  
  RESULTS
  Fifteen percent of patients had one or more CTCs. The presence of CTCs was found to be significantly associated with cervical involvement (83.33% vs 11.76%, p=0.00). No significant difference in CTC-positive rates was detected between the high-risk and high-intermediate-risk groups, and no significant correlation was found between CTCs and serum CA125/HE4, either by positive rates or exact serum levels of the conventional tumour markers. No more CTCs were detected after the first cycle of standard chemotherapy in this study, and no distant metastases or recurrence were found in the CTC-positive patients during the follow-up period.
  
  
  CONCLUSIONS
  The presence of CTCs was correlated with cervical involvement. Early-stage EC patients with CTCs may benefit from additional adjuvant therapies. Assessment of CTCs may be useful in the management of high-risk EC patients.
authors.affiliation: Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: T
authors.initials: T
authors.lastname: Ni
authors.affiliation: Laboratory of Gynaecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: X
authors.initials: X
authors.lastname: Sun
authors.affiliation: Fudan University Shanghai Cancer Centre, Shanghai, China.
authors.forename: B
authors.initials: B
authors.lastname: Shan
authors.affiliation: Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: S-L
authors.initials: SL
authors.lastname: Gu
authors.affiliation: Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: owangyudong@126.com.
authors.forename: Y-D
authors.initials: YD
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000473:pathology / Q000556:secondary / Q000628:therapy; D002584:Cervix Uteri / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000097:blood / Q000473:pathology / Q000556:secondary / Q000628:therapy; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology / Q000517:prevention & control / Q000628:therapy; D004717:Endometrium / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D009215:Myometrium / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000187:drug effects / Q000473:pathology*; D011506:Proteins / Q000032:analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000517:prevention & control / Q000556:secondary* / Q000601:surgery; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000517:prevention & control / Q000556:secondary* / Q000601:surgery; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human
keywords: CA125; Circulating tumour cells; Endometrial cancer; HE4