Enhancing Prediction Performance by Add-On Combining Circulating Tumor Cell Count, CD45neg EpCAMneg Cell Count on Colorectal Cancer, Advance, and Metastasis

Sherry Yueh-Hsia Chiu; Chia-Hsun Hsieh; Jeng-Fu You; Po-Yu Chu; Hsin-Yuan Hung; Pao-Hsien Chu; Min-Hsien Wu

doi:10.3390/cancers13112521

Enhancing Prediction Performance by Add-On Combining Circulating Tumor Cell Count, CD45^neg EpCAM^neg Cell Count on Colorectal Cancer, Advance, and Metastasis

Cancers (Basel). 2021 May 21;13(11):2521. doi: 10.3390/cancers13112521.

Authors

Sherry Yueh-Hsia Chiu^{1

2}, Chia-Hsun Hsieh^{3

4

5}, Jeng-Fu You^{5

6}, Po-Yu Chu⁷, Hsin-Yuan Hung^{5

6

8}, Pao-Hsien Chu^{5

9}, Min-Hsien Wu^{3

4

7

10

11}

Affiliations

¹ Department of Health Care Management, College of Management, and Healthy Aging Research Center, Chang Gung University, Taoyuan City 33302, Taiwan.
² Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan.
³ Division of Hematology-Oncology, Department of Internal Medicine, New Taipei City Municipal TuCheng Hospital, New Taipei City 23652, Taiwan.
⁴ Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33302, Taiwan.
⁵ Collage of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan.
⁶ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33302, Taiwan.
⁷ Ph.D. Program in Biomedical Engineering, Chang Gung University, Taoyuan City 33302, Taiwan.
⁸ Division of Colon and Rectal Surgery, New Taipei Municipal TuCheng Hospital, New Taipei City 23652, Taiwan.
⁹ The Cardiology Division, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33302, Taiwan.
¹⁰ Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan City 33302, Taiwan.
¹¹ Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City 24301, Taiwan.

Abstract

Conventional circulating tumor cell (CTC) enumeration could ignore the CTCs more relevant to cancer metastasis. Thus, negative selection CTC enumeration was proposed, by which information on two cellular biomarkers (numbers of CTCs and CD45^neg EpCAM^neg cells) can be obtained. By combining this approach with the conventional biomarker carcinoembryonic antigen (CEA), this study aimed to explore whether any combination of these biomarkers could improve the predictive performance for colorectal cancer (CRC) or its status. In this work, these two cell populations in healthy donors and CRC patients were quantified. Results revealed that enumeration of these two cell populations was able to discriminate healthy donors from CRC patients, even patients with non-advanced CRC. Moreover, the combination of the two cell populations showed improved performance (AUROC: 0.893) for CRC prediction over the use of only one population. Compared with CEA alone, the combination of the three biomarkers increased the performance (AUROC) for advanced CRC prediction from 0.643 to 0.727. Compared with that of CEA alone for metastatic CRC prediction, the AUROC was increased from 0.780 to 0.837 when the CTC count was included. Overall, this study demonstrated that the combination of these two cellular biomarkers with CEA improved the predictive performance for CRC and its status.

Keywords: cancer detection; cancer metastasis; carcinoembryonic antigen (CEA); circulating tumor cells (CTCs); colorectal cancer (CRC).

Abstract

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