Open Access

Circulating tumor cells expressing cancer stem cell marker CD44 as a diagnostic biomarker in patients with gastric cancer

  • Authors:
    • Toru Watanabe
    • Tomoyuki Okumura
    • Katsuhisa Hirano
    • Tetsuji Yamaguchi
    • Shinichi Sekine
    • Takuya Nagata
    • Kazuhiro Tsukada
  • View Affiliations

  • Published online on: November 24, 2016     https://doi.org/10.3892/ol.2016.5432
  • Pages: 281-288
  • Copyright: © Watanabe et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Epithelial cell adhesion molecule (EpCAM) is a marker for circulating tumor cells (CTCs) in various types of cancer, while cluster of differentiation 44 (CD44) is a marker for gastric cancer (GC) stem cells. To evaluate the clinical significance of CD44+ CTCs in patients with GC in the present study, the number of EpCAM+CD44+ and EpCAM+CD44‑ cells were detected in the peripheral blood of 26 GC patients and 12 healthy volunteers using flow cytometry. The number (mean ± standard deviation) of EpCAM+CD44+ cells in the GC patients and healthy volunteers was 69.9±52.0 and 0.91±2.10, respectively (P=0.0001), while that of EpCAM+CD44‑ cells was 59.1±88.0 and 9.83±9.91, respectively (P=0.0313). The sensitivity and specificity of EpCAM+CD44+ cell detection for the identification of GC patients were 92.3 and 100%, respectively. By contrast, the values of EpCAM+CD44‑ cell detection were 76.9 and 83.3%, respectively. The number of EpCAM+CD44+ cells in the GC patients was correlated with the disease stage (P=0.0423), the depth of the tumor (P=0.0314) and venous invasion (P=0.0184) in the resected tumor specimens, while the number of EpCAM+CD44‑ cells did not correlate with any clinicopathological factors. The number of EpCAM+CD44+ cells significantly decreased following surgical resection of the tumor or induction of systemic chemotherapy. Additionally, atypical cells with a high nuclear to cytoplasmic ratio were morphologically detected in the sorted EpCAM+CD44+ cells. These results suggested that CD44+ CTCs, but not CD44‑ CTCs, reflect the malignant status of the primary tumor in patients with GC, providing a candidate biomarker for diagnosis and treatment response.
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January-2017
Volume 13 Issue 1

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Spandidos Publications style
Watanabe T, Okumura T, Hirano K, Yamaguchi T, Sekine S, Nagata T and Tsukada K: Circulating tumor cells expressing cancer stem cell marker CD44 as a diagnostic biomarker in patients with gastric cancer. Oncol Lett 13: 281-288, 2017
APA
Watanabe, T., Okumura, T., Hirano, K., Yamaguchi, T., Sekine, S., Nagata, T., & Tsukada, K. (2017). Circulating tumor cells expressing cancer stem cell marker CD44 as a diagnostic biomarker in patients with gastric cancer. Oncology Letters, 13, 281-288. https://doi.org/10.3892/ol.2016.5432
MLA
Watanabe, T., Okumura, T., Hirano, K., Yamaguchi, T., Sekine, S., Nagata, T., Tsukada, K."Circulating tumor cells expressing cancer stem cell marker CD44 as a diagnostic biomarker in patients with gastric cancer". Oncology Letters 13.1 (2017): 281-288.
Chicago
Watanabe, T., Okumura, T., Hirano, K., Yamaguchi, T., Sekine, S., Nagata, T., Tsukada, K."Circulating tumor cells expressing cancer stem cell marker CD44 as a diagnostic biomarker in patients with gastric cancer". Oncology Letters 13, no. 1 (2017): 281-288. https://doi.org/10.3892/ol.2016.5432