Perioperative Circulating Tumor Cells (CTCs), MCTCs, and CTC-White Blood Cells Detected by a Size-Based Platform Predict Prognosis in Renal Cell Carcinoma

Table 1

Relationship of perioperative total CTCs, mesenchymal CTC, CTC-WBC, and clinical characteristics. CTCs: circulating tumor cells; WBC: white blood cells; TNM: tumor, node, metastasis; : case number; : statistical value.

Clinical parameters		Total CTC				Mesenchymal CTC				CTC-WBC
		Presurgery		Postsurgery		Presurgery		Postsurgery		Presurgery		Postsurgery
						Negative	Positive	Negative	Positive	Negative	Positive	Negative	Positive
Age
<50	32	13	19	17	15	9	23	13	19	28	4	29	3
≥50	99	45	54	55	44	42	57	41	58	88	11	85	14
			0.633		0.81		0.149		0.937		0.76		0.762
Sex
Male	83	35	48	44	39	37	46	30	53	70	13	69	14
Female	48	23	25	28	20	14	34	24	24	46	2	45	3
			0.523		0.555		0.081		0.121		0.051		0.107
Pathological subtypes
Clear-cell carcinoma	113	52	61	60	53	47	66	45	68	100	13	98	15
Others	18	6	12	12	6	4	14	9	9	16	2	16	2
			0.314		0.283		0.11		0.41		1		1
Differentiation
Low	22	7	15	13	9	7	15	11	11	19	3	21	1
Middle	102	48	54	57	45	41	61	42	60	92	10	88	14
High	7	3	4	2	5	3	4	1	6	5	2	5	2
			0.446		0.38		0.79		0.29		0.248		0.189
TNM stage
T1	112	52	60	63	49	43	69	45	67	99	13	97	15
T2	15	4	11	6	9	5	10	6	9	13	2	13	2
T3	4	2	2	3	1	3	1	3	1	4	0	4	0
			0.327		0.39		0.37		0.45		0.811		1
Types of surgery
Nephron-sparing surgery	79	35	44	51	28	27	52	34	45	68	11	68	11
Radical excision	52	23	29	21	31	24	28	20	32	48	4	46	6
			0.993		0.007		0.16		0.60		0.273		0.691
Renal score
Low risk	28	12	16	17	11	7	21	13	15	24	4	24	4
Middle risk	72	32	40	42	30	31	41	32	40	63	9	66	6
High risk	31	14	17	13	18	13	18	9	22	29	2	24	7
			0.983		0.243		0.23		0.28		0.576		0.126

Fluorescence microscopy images show three types of CTCs with positive expression of epithelial markers (EpCAM and CK8/18/19, red dots), biphenotypic markers (red dots and green dots), and mesenchymal markers (Vimentin and Twist, green dots). CTC-WBC was characterized as DAPI + CD45 + epithelial + and/or mesenchymal+. . EMT: epithelial-mesenchymal transition; CTC: circulating tumor cells; WBC: white blood cell; ISH: in situ hybridization.