Aneuploid Circulating Endothelial Cells with Prognostic Value in Locally Advanced Breast Cancer Patients After Neoadjuvant Chemotherapy

Minghui Li; Yuelin Liu; Xu Han; Tao Li; Zhizheng Zhang; Ningyi Xue; Mengdi Liang; Ge Ma; Tiansong Xia

doi:10.2147/BCTT.S487336

Aneuploid Circulating Endothelial Cells with Prognostic Value in Locally Advanced Breast Cancer Patients After Neoadjuvant Chemotherapy

Breast Cancer (Dove Med Press). 2024 Nov 12:16:761-768. doi: 10.2147/BCTT.S487336. eCollection 2024.

Authors

Minghui Li^#¹, Yuelin Liu^#¹, Xu Han^#¹, Tao Li², Zhizheng Zhang¹, Ningyi Xue¹, Mengdi Liang¹, Ge Ma¹, Tiansong Xia¹

Affiliations

¹ Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China.
² Department of Pathology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China.

^# Contributed equally.

Abstract

Background: Aneuploid circulating endothelial cells (CECs) are an indicator in breast cancer (BC). Significant changes of aneuploid CECs occurred during neoadjuvant chemotherapy (NCT). This study aimed to explore the predictive and prognostic values of aneuploid CECs in locally advanced breast cancer (LABC) patients with different NCT responses.

Methods: Breast cancer patients received an EC4-T4 NCT regimen. A novel subtraction enrichment and immunostaining fluorescence in situ hybridization (SE-iFISH) strategy was applied for the detection of CECs (CD45-/CD31+/DAPI+). Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of aneuploid CEC counts in distinguishing NCT-resistant patients from sensitive ones. All patients were observed for progression-free survival (PFS) and overall survival (OS).

Results: The CEC counts at any time point did not show the ability to predict the efficacy of NCT. The difference in the CECs between post-chemotherapy levels and baseline could be sufficient to distinguish chemotherapy-resistant cases from other cases in Hormone+Her-2-/+ (HR+) BC patients. Patients with reduction of CECs after all courses of NCT were associated with higher probability of PFS.

Conclusion: Variations in aneuploid CECs during NCT may predict chemotherapy response in patients with HR+ breast cancer. The decrease in the number of aneuploid CECs after all courses of NCT indicates better treatment outcomes in patients with LABC.

Keywords: aneuploidy; circulating endothelial cells; locally advanced breast cancer; neoadjuvant chemotherapy; prognosis.

Grants and funding

This study was supported by the Natural Science Foundation of China [grant numbers 82103562, 82203118 and 82404047], Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering [grant number 2021KFKT014], 333 high-level Talents Training Project of Jiangsu Province [grant number BRA2020380], and Young Scholars Fostering Fund of the First Affiliated Hospital of Nanjing Medical University [grant number PY2023009].