Heterogeneity of Circulating Tumor Cells in Neoadjuvant Chemotherapy of Breast Cancer

Molecules. 2018 Mar 22;23(4):727. doi: 10.3390/molecules23040727.


The biological properties of circulating tumor cells (CTCs), and their dynamics during neoadjuvant chemotherapy are important, both for disease progression prediction and therapeutic target determination, with the aim of preventing disease progression. The aim of our study was to estimate of different CTC subsets in breast cancer during the NACT (neoadjuvant chemotherapy). The prospective study includes 27 patients with invasive breast cancer, T2-4N0-3M0, aged 32 to 60 years. Venous heparinized blood samples, taken before and after biopsy, after each courses of chemotherapy (on days 3-7), and before surgical intervention, served as the material for this study. Different subsets of circulating tumor cells were determined on the basis of the expression of EpCAM, CD45, CD44, CD24, and N-Cadherin using flow cytometry. As the result of this study, it has been observed that significant changes in the quantity of the different subsets of circulating tumor cells in patients' blood were observed after carrying out the 3rd course of NACT. NACT causes significant changes in the quantity of six CTC subsets, with various combinations of stemness and epithelial-mesenchymal transition (EMT) properties.

Keywords: EMT; EpCAM-negative circulating tumor cells; NACT; breast cancer; heterogeneity of circulating tumor cells.

MeSH terms

  • Adult
  • Breast Neoplasms / metabolism*
  • CD24 Antigen / metabolism
  • Cadherins / metabolism
  • Epithelial-Mesenchymal Transition / physiology
  • Female
  • Flow Cytometry
  • Humans
  • Hyaluronan Receptors / metabolism
  • Leukocyte Common Antigens / metabolism
  • Male
  • Middle Aged
  • Neoplastic Cells, Circulating / metabolism*
  • Prospective Studies


  • CD24 Antigen
  • Cadherins
  • Hyaluronan Receptors
  • Leukocyte Common Antigens