Circulating Tumor Cells Expressing Krüppel-Like Factor 8 and Vimentin as Predictors of Poor Prognosis in Pancreatic Cancer Patients

• Published in: Cancer control 2021-01, Vol.28, p.10732748211027163-10732748211027163
• Main Authors: Zhu, Peng, Liu, Hui-Ying, Liu, Fu-Chen, Gu, Fang-Ming, Yuan, Sheng-Xian, Huang, Jian, Pan, Ze-Ya, Wang, Wei-Jun
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers, Tumor; Carcinoma; Female; Humans; Immunocytochemistry; Immunomagnetic separation; Kaplan-Meier Estimate; Kruppel-Like Transcription Factors - biosynthesis; Male; Medical prognosis; Mesenchyme; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplastic Cells, Circulating - metabolism; Original; Pancreatic cancer; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Peripheral blood; Phenotypes; Prognosis; Risk Factors; Tumor cells; Vimentin; Vimentin - biosynthesis
• ISSN: 1073-2748; 1526-2359; 1073-2748
• DOI: 10.1177/10732748211027163

Background: Circulating tumor cells (CTCs) with an epithelial-mesenchymal transition phenotype in peripheral blood may be a useful marker of carcinomas with poor prognosis. The aim of this study was to determine the prognostic significance of CTCs expressing Krüppel-like factor 8 (KLF8) and vimentin in pancreatic cancer (PC). Methods: CTCs were isolated by immunomagnetic separation from the peripheral blood of 40 PC patients before undergoing surgical resection. Immunocytochemistry was performed to identify KLF8+ and vimentin+ CTCs. The associations between CTCs and time to recurrence (TTR), clinicopathologic factors, and survival were assessed. Univariate and multivariate analyzes were performed to identify risk factors. Results: Patients with CTCs (n = 30) had a higher relapse rate compared to those without (n = 10) (70.0% vs 20.0%; P < 0.01). The proportion of KLF8+/vimentin+ CTCs to total CTCs was inversely related to TTR (r = −0.646; P < 0.01); TTR was reduced in patients with > 50% of CTCs identified as KLF8+/vimentin+ (P < 0.01). Independent risk factors for recurrence were perineural invasion and > 50% KLF8+/vimentin+ CTCs (both P < 0.05). Conclusion: Poor prognosis can be predicted in PC patients when > 50% of CTCs are positive for KLF8 and vimentin.