Molecular detection of epithelial-mesenchymal transition markers in circulating tumor cells from pancreatic cancer patients: Potential role in clinical practice

Table 1 Baseline circulating tumor cell characteristics of treatment-naïve patients with advanced pancreatic ductal adenocarcinoma according to circulating tumor cell status

Group	Patients n (%)
Number of patients with no CTC	23/107 (21.5)
Number of patients with ≥ 1 CTC	84/107 (78.5)
Number of patients with ≥ 6 CTC	55/107 (51.4)
Number of patients with E-CTCs	65/107(60.7)
Number of patients with E/M-CTCs	39/107 (36.4)
Number of patients with M-CTCs	49/107 (45.8)
CTC dynamic range
Total CTC	0-26
Median	6
E-CTC	1-11
E/M-CTC	0-26
M-CTC	0-9

CTC: Circulating tumor cells; E-CTC: Epithelial circulating tumor cells; M-CTC: Mesenchymal circulating tumor cells.

Table 2 Correlation between total circulating tumor cell status and clinicopathological factors of patients with pancreatic cancer

	Total CTC-negative patients (%)	Total CTC-positive patients (%)	P-value
Age, yr (median: 63, IQR: 52-76)
< 60	8/23 (34.8)	32/84 (38.1)	0.769
≥ 60	15/23 (65.2)	52/84 (61.9)
Gender
Male	16/23 (69.6)	47/84 (56.0)	0.313
Female	7/23 (30.4)	37/84 (44.0)
Ethnic group
Han ethnic group	14/23 (60.9)	59/84 (70.2)	0.346
Zhuang ethnic group	5/23 (21.7)	16/84 (19.1)
Li ethnic group	4/23 (17.4)	9/84 (10.7)
Differentiation
Well	3/23 (13.0)	7/84 (8.3)	0.435
Moderate	13/23 (56.5)	54/84 (64.3)
Poor	7/23 (30.5)	23/84 (27.4)
TNM stage
I	6/23 (26.1)	4/84 (4.8)	< 0.001
II	7/23 (30.4)	13/84 (15.5)
III	10/23 (43.5)	39/84 (46.4)
IV	0/23 (0)	28/84 (33.3)
Lymph node metastasis
Negative	13/23 (56.5)	34/84 (40.5)	0.023
Positive	10/23 (43.5)	50/84 (59.5)
Neural invasion
Negative	10/23 (43.5)	29/84 (34.5)	0.247
Positive	13/23 (56.5)	55/84 (65.5)
Distant metastasis
Negative	23/23 (100)	56/84 (66.7)	< 0.001
Positive	0/23 (0)	28/84 (33.3)

CTC: Circulating tumor cell; IQR: Interquartile range.

Table 3 Univariate and multivariate Cox regression analyses of prognostic factors for overall survival in pancreatic cancer

Predictor	Univariate analysis			Multivariate analysis
	HR	95%CI	P-value	HR	95%CI	P-value
Age, < 60 vs ≥ 60	0.818	0.798-1.017	0.792
Gender (female vs male)	0.928	0.781-1.130	0.952
Differentiation (well vs moderate vs poor)	1.045	0.873-1.186	0.134
Ethnic group (Han/Zhuang/Li)	0.917	0.834-1.048	0.866
TNM stage (I/II vs III/IV)	1.452	1.215-1.475	< 0.001	1.148	1.031-1.268	0.011
Lymph node metastasis (negative vs positive)	1.287	1.048-1.364	0.007	1.198	1.036-1.380	0.017
Neural invasion (negative vs positive)	1.008	0.781-1.155	0.949
Distant metastasis (negative vs positive)	1.426	1.236-1.710	< 0.001	1.521	1.256-1.887	< 0.001
CTC, < 6 vs ≥ 6	1.849	1.717-2.238	< 0.001	1.851	1.637-2.173	< 0.001

CTC: Circulating tumor cells.

Table 4 Correlation between total circulating tumor cell status and clinicopathological factors of patients with pancreatic cancer

		Epithelia CTC (%)			Hybrid CTC (%)			Mesenchymal CTC (%)
		Positive	Negative	P-value	Positive	Negative	P-value	Positive	Negative	P-value
Age (yr)	< 60	24/65	16/42	> 0.9	12/39	28/68	0.18	21/49	19/58	0.19
		(36.9)	(38.1)		(30.8)	(41.2)		(42.9)	(32.8)
	≥ 60	41/65	26/42		27/39	40/68		28/49	39/58
		(63.1)	(61.9)		(69.2)	(58.8)		(57.1)	(67.2)
Gender	Male	37/65	26/42	0.56	24/39	39/68	0.56	28/49	35/58	0.77
		(56.9)	(61.9)		(61.5)	(57.4)		(57.1)	(60.3)
	Female	28/65	16/42		15/39	29/68		21/49	23/58
		(43.1)	(38.1)		(38.5)	(42.6)		(42.9)	(39.7)
Differentiation	Well	6/65	4/42	0.21	4/39	6/68	0.97	5/49	5/58	0.84
		(9.2)	(9.5)		(10.3)	(8.8)		(8.1)	(9.3)
	Moderate	38/65	29/42		24/39	43/68		31/49	36/58
		(58.5)	(69.1)		(61.5)	(63.2)		(64.9)	(60.5)
	Poor	21/65	9/42		11/39	19/68		13/49	17/58
		(32.3)	(21.4)		(28.2)	(28)		(27)	(30.2)
TNM stage	I	4/65	6/42	0.29	3/39	7/68	0.59	1/49	9/58	< 0.01
		(6.1)	(14.3)		(7.7)	(10.3)		(2)	(15.5)
	II	13/65	7/42		9/39	11/68		5/49	15/58
		(20)	(16.7)		(23.1)	(16.2)		(10.2)	(25.9)
	III	30/65	19/42		17/39	32/68		22/49	27/58
		(46.2)	(45.2)		(43.6)	(47.1)		(44.9)	(46.6)
	IV	18/65	10/42		10/39	18/68		21/49	7/58
		(27.7)	(23.8)		(25.6)	(26.4)		(42.9)	(12)
Lymph node metastasis	Negative	25/65	22/42	0.08	18/39	29/68	0.78	24/49(49.0)	23/58	0.26
		(38.5)	(52.4)		(46.2)	(42.6)			(39.7)
	Positive	40/65	20/42		21/39	39/68		25/49	35/58
		(61.5)	(47.6)		(53.8)	(57.4)		(51)	(60.3)
Neural invasion	Negative	22/65	17/42	0.38	18/39	21/68	0.78	17/49	22/58	0.77
		(33.8)	(40.5)		(46.2)	(42.6)		(34.7)	(37.9)
	Positive	43/65	25/42		21/39	39/68		32/49	36/58
		(66.2)	(59.5)		(53.8)	(57.4)		(65.3)	(62.1)
Distant metastasis	Negative	46/65	33/42	0.25	27/39	52/68	0.26	25/49	54/58	< 0.01
		(70.8)	(78.6)		(69.2)	(76.5)		(51)	(93.1)
	Positive	19/65	9/42		12/39	16/68		24/49	4/58
		(29.2)	(21.4)		(30.8)	(23.5)		(49)	(6.9)
Ethnic group	Li ethnic group	8/65	5/42	0.98	5/39	8/68	0.52	5/49	8/58	0.24
		(12.3)	(11.9)		(12.8)	(11.8)		(10.2)	(13.8)
	Han ethnic group	44/65	29/42		25/39	48/68		32/49	41/58
		(67.7)	(69.1)		(64.1)	(70.6)		(65.3)	(70.7)
	Zhuang ethnic group	13/65	8/42		9/39	12/68		12/49	9/58
		(20)	(19)		(23.1)	(17.6)		(24.5)	(15.5)

CTC: Circulating tumor cells.