Metastatic Spread Emerging From Liver Metastases of XXXX : Does the Seed Leave the Soil Again?

@entity5 @entity1 @entity14 @entity3
OBJECTIVE: To investigate whether liver @entity3 contribute to metastatic spread of @entity14 ( @entity14 ) by shedding intact @entity5 cells. BACKGROUND: Metastases represent the primary cause of death in @entity14 . Understanding the metastatic activity of @entity3 and which @entity1 are at high risk for @entity5 cell dissemination may, therefore, have significant influence on @entity5 care in the future. METHODS: Circulating @entity5 cells (CTCs) were detected in the hepatic inflow (portal venous blood [PVB]) and outflow compartment (hepatic venous blood [HVB]) of a training (n=55) and validation (n=50) set using the CellSearch system. Isolated CTC from the HVB were subjected to gene expression analyses by quantitative polymerase chain reaction. RESULTS: CTC detection rate (37.2% vs 19.6%; P=0.04) and count (mean: 12.7, SEM:  5.9 vs 1.9;  1.2; P=0.01) were significantly higher in HVB compared to PVB. The increased CTC detection rate (54% vs 11.4%; P<0.001) and CTC count (14.7  5.1 vs 1.1  0.6; P<0.001) in the HVB compared to the PVB compartment was confirmed in the validation cohort. Expression of epithelial markers and genes involved in cell-to-cell and cell-to-matrix adhesion was reduced in CTC compared to @entity5 cells in liver @entity3 . @entity3 size greater than 5cm was associated with CTC shedding from established liver @entity3 in the training and validation cohorts. CONCLUSIONS: Colorectal liver @entity3 shed intact @entity5 cells with an invasive phenotype. @entity3 size serves as a surrogate marker for metastatic activity of colorectal liver @entity3 .
