Circulating tumour cells as a biomarker for diagnosis and staging in pancreatic cancer

J. S. Ankeny, C. M. Court, S. Hou, Q. Li, M. Song, D. Wu, J. F. Chen, T. Lee, M. Lin, S. Sho, M. M. Rochefort, M. D. Girgis, J. Yao, Z. A. Wainberg, V. R. Muthusamy, R. R. Watson, T. R. Donahue, O. J. Hines, H. A. Reber, T. G. GraeberH. R. Tseng, J. S. Tomlinson

Research output: Contribution to journalArticlepeer-review

120 Scopus citations


Background:Current diagnosis and staging of pancreatic ductal adenocarcinoma (PDAC) has important limitations and better biomarkers are needed to guide initial therapy. We investigated the performance of circulating tumour cells (CTCs) as an adjunctive biomarker at the time of disease presentation.Methods:Venous blood (VB) was collected prospectively from 100 consecutive, pre-treatment patients with PDAC. Utilising the microfluidic NanoVelcro CTC chip, samples were evaluated for the presence and number of CTCs. KRAS mutation analysis was used to compare the CTCs with primary tumour tissue. CTC enumeration data was then evaluated as a diagnostic and staging biomarker in the setting of PDAC.Results:We found 100% concordance for KRAS mutation subtype between primary tumour and CTCs in all five patients tested. Evaluation of CTCs as a diagnostic revealed the presence of CTCs in 54/72 patients with confirmed PDAC (sensitivity=75.0%, specificity=96.4%, area under the curve (AUROC)=0.867, 95% CI=0.798-0.935, and P<0.001). Furthermore, a cut-off of ≥3 CTCs in 4 ml VB was able to discriminate between local/regional and metastatic disease (AUROC=0.885; 95% CI=0.800-0.969; and P<0.001).Conclusion:CTCs appear to function well as a biomarker for diagnosis and staging in PDAC.

Original languageEnglish (US)
Pages (from-to)1367-1375
Number of pages9
JournalBritish Journal of Cancer
Issue number12
StatePublished - Jun 14 2016
Externally publishedYes

Bibliographical note

Funding Information:
The NanoVelcro Chips used in this research were supported by research grants (R33CA174562 and U01 CA198900) and an SBIR grant (R44 CA180482) from National Institute of Health.


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