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Portal versus peripheral circulating tumor cells as prognostic biomarkers in patients with stage I-III pancreatic ductal adenocarcinoma

  • 0Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Endoscopy +

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February 7, 2025

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February 7, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Detecting portal venous circulating tumor cells (CTCs) in pancreatic ductal adenocarcinoma (PDAC) may better predict metastasis and survival than peripheral CTCs. Higher portal CTCs indicate tumor aggression and poorer outcomes.

Area Of Science

  • Oncology
  • Gastroenterology
  • Surgical Oncology

Background

  • Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy.
  • Accurate prediction of micrometastasis and survival is crucial for PDAC management.
  • Circulating tumor cells (CTCs) are emerging biomarkers for cancer metastasis and prognosis.

Purpose Of The Study

  • To investigate whether portal venous CTCs better reflect vascular metastasis and predict survival in PDAC patients compared to peripheral CTCs.
  • To evaluate the correlation between portal CTCs and tumor aggressiveness or locoregional metastasis.
  • To assess the prognostic value of portal and peripheral CTCs in early-stage PDAC.

Main Methods

  • A prospective cohort study involving 35 patients with stage I-III PDAC.
  • Endoscopic ultrasound-guided sampling for portal venous blood and simultaneous peripheral blood collection.
  • CTCs detected using EpCAM and mucin1 antibodies, quantified as cells/8 mL.

Main Results

  • High detection rates for both portal (94.3%) and peripheral (82.9%) CTCs.
  • Advanced PDAC with locoregional metastasis showed significantly higher portal CTCs (P < 0.05), unlike peripheral CTCs.
  • Elevated portal CTCs (≥8) and peripheral CTCs (≥3) were independently associated with significantly poorer survival (P = 0.001 and P = 0.002, respectively).

Conclusions

  • Both portal and peripheral CTC counts correlate with poorer survival in early-stage PDAC.
  • Portal venous CTCs appear to be a more sensitive indicator of tumor aggression and locoregional metastasis than peripheral CTCs.
  • Portal venous CTC detection may offer superior prognostic value for PDAC patients.