Ezrin-polarized circulating tumor cells as a potential biomaker in hepatocellular carcinoma

Background/Purpose The dynamic polarization of circulating tumor cells (CTCs) plays a major role during metastasis. During this process, tumor cells de- and repolarize. The aim of this study is to evaluate the potential of polarized CTCs (p-CTCs) as a diagnostic marker in patients with hepatocellular carcinoma (HCC).

Methods In this presented study, the CTCs were isolated using Oncoquick®. The immunofluorescence staining of the CTCs followed using Anti-Ezrin-Alexa-Fluor 488® to detect the cytoskeletal and membrane associated protein Ezrin. This study included blood samples of 21 patients with HCC and 18 patients with a non-malignant-liver disease (NMLD).

Results The most common underlying disease was with 33,33 % (n = 7) alcohol abuse followed by non-alcoholic-liver disease (NASH) with 28,57 % (n = 6) and diabetes mellitus type 2 in 23,81 % (n = 5) of the patients. 11 HCC-patients (52,38 %) were suffering from a liver cirrhosis. Most of the patients could be categorized in BCLC-Stadium C (n = 7) followed by BCLC-stadium B (n = 5) and BCLC-stadium A (n = 7). Only 2 patients were BCLC stadium 0. CTCs (1,2 CTCs/ml (0,4-3 CTCs/ml) were detected in 19 HCC patients (90,48 %). The false positivity rate was 16,67 % (n = 3). P-CTCs were found in 15 HCC patients (71,43 %). The false positivity rate was 11,11 % (n = 2). Consequently, the HCC group shows significantly more p-CTCs then the NMLD-Group (p=0.0005). A negative correlation between the tumor size, the BCLC Stadium and the number of p-CTCs (r=-0,309893, rho=-0,216559, p=0,17, p=0,34) was found.

Conclusion The presented results for the proof of polarized CTCs could play an important role in the future study of molecular characterizations of CTCs in the context of liver cancer and offer new ways in the diagnosis of HCC.

Publication History

Article published online:
04 January 2021