Clinical significance of circulating tumor cells and circulating tumor vascular endothelial cells in the evaluation of the efficacy of neoadjuvant chemotherapy for breast cancer
Objective To evaluate the potential clinical value of detecting the number of circulating tumor cells (CTC) and circulating tumor endothelial cells (CTEC) using SE-iFISH method before and after neoadjuvant chemotherapy in patients with breast cancer.Methods According to the inclusion and exclusion criteria,periph-eral blood samples (5 ml) were collected from breast cancer patients who were scheduled to undergo neoadjuvant chemotherapy at Cancer Hospital Affiliated to Inner Mongolia Medical University from December 2021 to Decem-ber 2022.CTCs and CTECs were detected using the SE-iFISH method.CTC positivity was defined as the presence of≥3 CTCs,while CTEC positivity was defined as the presence of ≥1 CTEC.Results The median CTC count decreased from M (P25,P75)=3 (2,5) before neoadjuvant chemotherapy to M (P25,P75)=1 (0.25,1.75) after neoadju-vant chemotherapy.The median CTEC count decreased from M (P25,P75)=3(1,3) before neoadjuvant chemothera-py to M (P25,P75)=0 (0,0) after neoadjuvant chemotherapy.Among the 40 enrolled patients,18 patients were as-sessed as effective and 22 patients were assessed as ineffective based on the Miller-Payne pathological criteria (gold standard) for neoadjuvant chemotherapy evaluation.Using the change in the number of CTCs as the evalua-tion criterion,24 patients were assessed as effective and 16 patients were assessed as ineffective.Compared to the gold standard,the sensitivity of CTC evaluation was 77.8％,and the specificity was 54.6％,with McNemar test showing no statistical difference between the two methods (P=0.180),and there was fair agreement (Kappa=0.314,P<0.05).Using the change in the number of CTECs as the evaluation criterion,35 patients were assessed as effec-tive and 5 patients were assessed as ineffective.The sensitivity of CTEC detection was 94.4％,and specificity was 18.2％.McNemar test showed a significant statistical difference between the two methods for evaluating efficacy (P<0.001),and there was weak agreement (Kappa=0.116,P>0.05).Conclusion The changes in CTC and CTEC counts before and after neoadjuvant chemotherapy are correlated with the efficacy of neoadjuvant chemotherapy.Changes in CTCs can,to some extent,reflect the efficacy of neoadjuvant chemotherapy and may serve as a predic-tive indicator for neoadjuvant chemotherapy evaluation.Further research is needed to confirm the predictive role of CTEC changes in neoadjuvant chemotherapy efficacy.
Breast neoplasmsChemoradiotherapy,adjuvantNeoplastic cells,circulatingTreatment outcome
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