Clinical significance of Ki67 and circulating tumor cells with an epithelial-mesenchymal transition phenotype in non-small cell lung cancer

Huajian Peng; Xiang Tan; Yongyong Wang; Lei Dai; Guanbiao Liang; Jianji Guo; Mingwu Chen

Clinical significance of Ki67 and circulating tumor cells with an epithelial-mesenchymal transition phenotype in non-small cell lung cancer

Am J Transl Res. 2020 Jun 15;12(6):2916-2928. eCollection 2020.

Authors

Huajian Peng¹, Xiang Tan¹, Yongyong Wang¹, Lei Dai¹, Guanbiao Liang¹, Jianji Guo¹, Mingwu Chen¹

Affiliation

¹ Department of Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.

PMID: 32655819
PMCID: PMC7344100

Abstract

Circulating tumor cells (CTCs) are a heterogeneous population of tumor cells with distinct clinical and biological properties. The aim of the present study was to evaluate the relationship between CTCs with the epithelial-mesenchymal transition phenotype (CTC EMT) and the proliferative marker Ki67, and their prognostic value in non-small cell lung cancer (NSCLC). CTCs were isolated from the peripheral blood of 84 NSCLC patients using the CanPatrol^TM CTC enrichment method, and the expression of Ki67 in tumor tissues were detected by immunohistochemistry. Almost two-thirds (61/84) of the patients were positive for CTC EMT, and 55 (65.4%) patients had high in-situ expression of Ki67 (≥ 14%) in the tumor tissues. CTC EMT was not significantly associated with tumor size and differentiation, age, gender and histological type, but correlated with lymphatic metastasis, tumor stage and Ki67 overexpression. Furthermore, the CTC EMT+ NSCLC patients had a significantly lower recurrence-free survival (RFS) and overall survival (OS) compared to the negative patients. Similarly, Ki67 levels ≥ 14% were associated with a significantly lower RFS and OS. In conclusion, CTC EMT is significantly related to Ki67 expression, and is a risk factor of NSCLC.

Keywords: Circulating tumor cell; Ki67; epithelial-mesenchymal; non-small-cell lung cancer; survival.