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Open AccessArticle

Association Between Microsatellite Instability Status and Peri-Operative Release of Circulating Tumour Cells in Colorectal Cancer

1
Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia
2
Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney 2145, Australia
3
Department of Colorectal Surgery, Concord Hospital and Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney 2137, Australia
4
Liverpool Clinical School, Western Sydney University, Sydney 2170, Australia
*
Authors to whom correspondence should be addressed.
Cells 2020, 9(2), 425; https://doi.org/10.3390/cells9020425 (registering DOI)
Received: 8 January 2020 / Revised: 7 February 2020 / Accepted: 11 February 2020 / Published: 12 February 2020
Microsatellite instability (MSI) in colorectal cancer (CRC) is a marker of immunogenicity and is associated with an increased abundance of tumour infiltrating lymphocytes (TILs). In this subgroup of colorectal cancer, it is unknown if these characteristics translate into a measurable difference in circulating tumour cell (CTC) release into peripheral circulation. This is the first study to compare MSI status with the prevalence of circulating CTCs in the peri-operative colorectal surgery setting. For this purpose, 20 patients who underwent CRC surgery with curative intent were enrolled in the study, and peripheral venous blood was collected at pre- (t1), intra- (t2), immediately post-operative (t3), and 14–16 h post-operative (t4) time points. Of these, one patient was excluded due to insufficient blood sample. CTCs were isolated from 19 patients using the IsofluxTM system, and the data were analysed using the STATA statistical package. CTC number was presented as the mean values, and comparisons were made using the Student t-test. There was a trend toward increased CTC presence in the MSI-high (H) CRC group, but this was not statistically significant. In addition, a Poisson regression was performed adjusting for stage (I-IV). This demonstrated no significant difference between the two MSI groups for pre-operative time point t1. However, time points t2, t3, and t4 were associated with increased CTC presence for MSI-H CRCs. In conclusion, there was a trend toward increased CTC release pre-, intra-, and post-operatively in MSI-H CRCs, but this was only statistically significant intra-operatively. When adjusting for stage, MSI-H was associated with an increase in CTC numbers intra-operatively and post-operatively, but not pre-operatively.
Keywords: circulating tumour cells; colorectal cancer; colorectal surgery; microsatellite instability circulating tumour cells; colorectal cancer; colorectal surgery; microsatellite instability
MDPI and ACS Style

Toh, J.W.; Lim, S.H.; MacKenzie, S.; de Souza, P.; Bokey, L.; Chapuis, P.; Spring, K.J. Association Between Microsatellite Instability Status and Peri-Operative Release of Circulating Tumour Cells in Colorectal Cancer. Cells 2020, 9, 425.

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