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Open AccessArticle

Sequential Circulating Tumor Cell Counts in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma: Monitoring the Treatment Response

1
Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
2
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan
3
Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
4
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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Division of Hematology/Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
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Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
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Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung 404, Taiwan
9
Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
10
Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan
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Department of Laboratory Medicine, Linko Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(1), 188; https://doi.org/10.3390/jcm9010188
Received: 15 December 2019 / Revised: 5 January 2020 / Accepted: 8 January 2020 / Published: 10 January 2020
(This article belongs to the Special Issue Circulating Biomarkers as a Liquid Biopsy for Cancer)
Hepatocellular carcinoma (HCC) is among the most common causes of cancer death in men. Whether or not a longitudinal follow-up of circulating tumor cells (CTCs) before and at different time points during systemic/targeted therapy is useful for monitoring the treatment response of patients with locally advanced or metastatic HCC has been evaluated in this study. Blood samples (n = 104) were obtained from patients with locally advanced or metastatic HCC (n = 30) for the enrichment of CTCs by a negative selection method. Analysis of the blood samples from patients with defined disease status (n = 81) revealed that those with progressive disease (PD, n = 37) had significantly higher CTC counts compared to those with a partial response (PR) or stable disease (SD; n = 44 for PR + SD, p = 0.0002). The median CTC count for patients with PD and for patients with PR and SD was 50 (interquartile range 21–139) and 15 (interquartile range 4–41) cells/mL of blood, respectively. A longitudinal analysis of patients (n = 17) after a series of blood collections demonstrated that a change in the CTC count correlated with the patient treatment response in most of the cases and was particularly useful for monitoring patients without elevated serum alpha-fetoprotein (AFP) levels. Sequential CTC enumeration during treatment can supplement standard medical tests and benefit the management of patients with locally advanced or metastatic HCC, in particular for the AFP-low cases. View Full-Text
Keywords: circulating tumor cells; hepatocellular carcinoma; longitudinal follow-up; alpha-fetoprotein circulating tumor cells; hepatocellular carcinoma; longitudinal follow-up; alpha-fetoprotein
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Rau, K.-M.; Liu, C.-T.; Hsiao, Y.-C.; Hsiao, K.-Y.; Wang, T.-M.; Hung, W.-S.; Su, Y.-L.; Liu, W.-C.; Wang, C.-H.; Hsu, H.-L.; Chuang, P.-H.; Cheng, J.-C.; Tseng, C.-P. Sequential Circulating Tumor Cell Counts in Patients with Locally Advanced or Metastatic Hepatocellular Carcinoma: Monitoring the Treatment Response. J. Clin. Med. 2020, 9, 188.

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