Correlation between mesenchymal circulating tumor cells and prognosis of urologic malignancies: a single-center...

To evaluate the correlation of circulating tumor cells (CTCs) and mesenchymal CTCs (M-CTCs) with clinical characteristics and survival of patients with urologic malignancies.

The clinical data of 52 patients with urinary system malignancy in Henan Provincial People's Hospital were retrospectively analyzed (40 cases of renal malignant tumor, 7 cases of prostate cancer, 3 cases of urothelial carcinoma, 1 case of testis cancer, and 1 case of penile cancer). The CTC counts of patients were collected, and the expression of epithelial-mesenchymal transition phenotype in CTCs was evaluated. The relationship of different types of CTC counts with tumor stage, location, size, metastasis, and differentiation, as well as their effect on progression-free survival (PFS) were analyzed.

We detected CTCs in all patients with urinary system malignancy. The positive rates of epithelial CTCs (E-CTC), M-CTCs, and epithelial/mesenchymal CTCs (E/M-CTCs) were 34.62%, 26.92% and 94.23%, respectively. Total CTCs (T-CTCs), M-CTCs and E/M-CTCs were correlated with distant metastasis (Z=-3.052, -3.574, -2.898; all P<0.005). M-CTC count was correlated with lymph node metastasis (Z=-3.125; P=0.002). Furthermore, the presence of T-CTCs ≥13.5, M-CTC ≥0.5 or E/M-CTCs ≥9.5 per 5 ml of blood was correlated with worse PFS in patients with urinary system malignancy.

M-CTC and E/M-CTC counts correlate with the prognosis of patients with urinary system malignancy. Higher M-CTC and E/M-CTC counts are risk factors for worse prognosis in patients with urinary system malignancies. All in all, M-CTC count is a valuable tumor biomarker for urologic malignancies.