lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Role of Circulating Tumor Cells as Prognostic Marker in Patients with Gestational Choriocarcinoma

43 Pages Posted: 27 Sep 2018

See all articles by Minzhi Hou

Minzhi Hou

Sun Yat-sen University (SYSU)

Shanyang He

Sun Yat-sen University (SYSU)

Zhiming Ding

Sun Yat-sen University (SYSU)

Yongjiang Zheng

Sun Yat-sen University (SYSU)

Manman Xu

Sun Yat-sen University (SYSU)

Xinlin Chen

Guangzhou University of Chinese Medicine - School of Basic Medical Science

Hui Zhang

Sun Yat-sen University (SYSU)

Chao Zeng

Sun Yat-sen University (SYSU); Guangdong Medical University

Cong Sun

Sun Yat-sen University (SYSU)

Wenting Jiang

Sun Yat-sen University (SYSU)

Han Wang

Sun Yat-sen University (SYSU)

Hongwei Shen

Sun Yat-sen University (SYSU)

Yang Zhang

University of Texas at El Paso

Jing Liu

Guangzhou Medical University - Guangdong Women and Children Hospital

Shijun Sun

Sun Yat-sen University (SYSU)

Neng Jiang

Sun Yat-sen University (SYSU)

Yongmei Cui

Sun Yat-sen University (SYSU)

Yu Sun

Sun Yat-sen University (SYSU)

Yangshan Chen

Sun Yat-sen University (SYSU)

Jessica Cao

University of Calgary

Chunlin Wang

Chapter Diagnostics

Mengzhen Li

MyGene Diagnostics

Yi Zhang

Cedars Sinai Medical Center

Jianhong Wang

Jinan University - Shenzhen People’s Hospital

Millicent Lin

Harvard University - Harvard Medical School

Zun-Fu Ke

Sun Yat-sen University (SYSU) - Molecular Diagnosis and Gene Testing Center

More...

Abstract

Background: To investigate whether circulating tumor cells (CTCs) are detectable in patients with gestational choriocarcinoma (GC) and evaluate the prognostic value of CTC enumeration.  

Methods: In this multicenter study, the presence of CTCs was examined in 180 GC patients using a semi-automated NanoVelcro system, among whom 106 patients underwent CTC re-evaluation after one cycle of chemotherapy.

Findings: Approximately 96% of the GC patients contained ≥2 CTCs in 7.5 mL of blood. The number of CTCs per 7.5 mL of blood was much higher in patients with distant metastases (n=95; range, 0 to 104) than in patients without distant metastases (n=85; range, 0 to 6). Applying a 90-patient training and 90-patient validation cohort, a cutoff value of ≥6 CTCs was defined as the prognostic threshold for progression-free survival (PFS) and overall survival (OS). The presence of ≥6 CTCs was significantly associated with worse PFS and OS (both P<0.001). A multivariate analysis showed that the CTC number (≥6 CTCs) was the strongest predictor of OS (hazard ratio [HR], 15.8; 95% confidence interval [CI], 4.3-57.9; P<0.001). The number of CTCs decreased after one cycle of chemotherapy; univariate analyses demonstrated that the CTC count after the first chemotherapy cycle was a strong predictor for OS (HR, 36.1; 95% CI, 4.8-271.5; P<0.001).  

Interpretation: CTCs are a promising prognostic factor for GC. The absolute CTC count after one cycle of chemotherapy in the context of this disease is a strong predictor of chemotherapy response.  

Funding: This work was supported by grants from the National Natural Science Foundation of China (30900650, 81372501, 81572260 and 81773299), the Guangdong Natural Science Foundation (2011B031800025, S2012010008378, 2015A030313036 and 2015A030313036), and the Guangzhou and Guangdong/Guangzhou Science and Technology Planning Program (2014J4100132, 2012B031800115, 2013B02180021, 2015A020214010, 2016A020215055, 201704020094, 16ykjc08 and 2015ykzd07).

Declaration of Interest: No potential conflicts of interest were disclosed.

Ethical Approval: Our study was approved by the Medical Ethics Committee of each independent center.

Keywords: Gestational choriocarcinoma (GC); Circulating tumor cells (CTCs); Cutoff for CTC count; Prognostic marker; Chemotherapy

Suggested Citation

Hou, Minzhi and He, Shanyang and Ding, Zhiming and Zheng, Yongjiang and Xu, Manman and Chen, Xinlin and Zhang, Hui and Zeng, Chao and Sun, Cong and Jiang, Wenting and Wang, Han and Shen, Hongwei and Zhang, Yang and Liu, Jing and Sun, Shijun and Jiang, Neng and Cui, Yongmei and Sun, Yu and Chen, Yangshan and Cao, Jessica and Wang, Chunlin and Li, Mengzhen and Zhang, Yi and Wang, Jianhong and Lin, Millicent and Ke, Zun-Fu, Role of Circulating Tumor Cells as Prognostic Marker in Patients with Gestational Choriocarcinoma (August 28, 2018). Available at SSRN: https://ssrn.com/abstract=3244818 or http://dx.doi.org/10.2139/ssrn.3244818

Minzhi Hou

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Shanyang He

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Zhiming Ding

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Yongjiang Zheng

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Manman Xu

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Xinlin Chen

Guangzhou University of Chinese Medicine - School of Basic Medical Science

Guangzhou
China

Hui Zhang

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Chao Zeng

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Guangdong Medical University

620 Renmin N Rd, Yuexiu Qu
Guangzhou Shi
Guangdong Sheng, 510000
China

Cong Sun

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Wenting Jiang

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Han Wang

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Hongwei Shen

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Yang Zhang

University of Texas at El Paso

500 W University Ave
El Paso, TX 79902
United States

Jing Liu

Guangzhou Medical University - Guangdong Women and Children Hospital

Guangdong
China

Shijun Sun

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Neng Jiang

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Yongmei Cui

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Yu Sun

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Yangshan Chen

Sun Yat-sen University (SYSU)

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Jessica Cao

University of Calgary

University Drive
Calgary, Alberta T2N 1N4
Canada

Chunlin Wang

Chapter Diagnostics

Menlo Park, CA 94025
United States

Mengzhen Li

MyGene Diagnostics

Guangzhou International Biotech Island
guangdong
China

Yi Zhang

Cedars Sinai Medical Center

8700 Beverly Blvd.
Los Angeles, CA 90048
United States

Jianhong Wang

Jinan University - Shenzhen People’s Hospital

Huang Pu Da Dao Xi 601, Tian He District
Guangzhou, Guangdong 510632
China

Millicent Lin

Harvard University - Harvard Medical School

25 Shattuck St
Boston, MA 02115
United States

Zun-Fu Ke (Contact Author)

Sun Yat-sen University (SYSU) - Molecular Diagnosis and Gene Testing Center ( email )

Guangzhou, Guangdong
China

Click here to go to TheLancet.com

Paper statistics

Abstract Views
289
Downloads
16
PlumX Metrics