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Association Between Microsatellite Instability Status and Peri-Operative Release of Circulating Tumour Cells in
James W T Toh1,2,3, Stephanie H Lim1, Scott MacKenzie4
1Medical Oncology, Ingham Institute of Applied Research, School of Medicine, Western Sydney University and SWS Clinical School, UNSW Sydney 2170, NSW, Australia.
Cells
|February 16, 2020
Summary
Microsatellite instability-high (MSI-H) colorectal cancer (CRC) showed a trend toward increased circulating tumor cell (CTC) release, particularly during and after surgery. This suggests MSI status may influence CTC shedding in the peri-operative period.
Area of Science:
- Oncology
- Cancer Biology
- Surgical Oncology
Background:
- Microsatellite instability (MSI) in colorectal cancer (CRC) correlates with immunogenicity and tumor-infiltrating lymphocytes (TILs).
- The relationship between MSI status and circulating tumor cell (CTC) shedding in the peri-operative setting of CRC surgery remains unexplored.
Purpose of the Study:
- To investigate whether MSI status in colorectal cancer impacts the prevalence of circulating tumor cells (CTCs) during the peri-operative period.
- This study aims to be the first to compare MSI status with CTC prevalence in patients undergoing colorectal cancer surgery.
Main Methods:
- Nineteen patients undergoing colorectal cancer surgery with curative intent were enrolled.
- Peripheral blood samples were collected at four peri-operative time points: pre-operative, intra-operative, immediately post-operative, and 14-16 hours post-operative.
- Circulating tumor cells (CTCs) were isolated using the Isoflux system, and data were analyzed using statistical methods including Student's t-test and Poisson regression.
Main Results:
- A trend towards increased CTC presence was observed in the MSI-high (MSI-H) CRC group, though not statistically significant pre-operatively.
- Poisson regression analysis, adjusting for cancer stage, revealed a significant increase in CTC presence for MSI-H CRCs intra-operatively (t2) and post-operatively (t3, t4).
- While a trend for increased CTC release was noted across all time points for MSI-H CRCs, statistical significance was primarily observed intra-operatively and post-operatively when adjusted for stage.
Conclusions:
- There is a trend suggesting increased peri-operative CTC release in MSI-H colorectal cancer.
- MSI-H status is associated with a significant increase in CTC numbers intra-operatively and post-operatively, especially when adjusted for cancer stage.
- These findings highlight a potential link between MSI status and CTC dynamics in the surgical management of colorectal cancer.
