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Cancer associated macrophage-like cells and prognosis of esophageal cancer after chemoradiation therapy

2020; BioMed Central; Volume: 18; Issue: 1 Linguagem: Inglês

10.1186/s12967-020-02563-x

1479-5876

Daniel J. Gironda, Daniel L. Adams, Jianzhong He, Ting Xu, Hui Gao, Yawei Qiao, Ritsuko Komaki, James M. Reuben, Zhongxing Liao, Mariela Blum‐Murphy, Wayne L. Hofstetter, Cha‐Mei Tang, Steven H. Lin,

Esophageal and GI Pathology

Abstract Background Cancer Associated Macrophage-Like cells (CAMLs) are polynucleated circulating stromal cells found in the bloodstream of numerous solid-tumor malignancies. Variations within CAML size have been associated with poorer progression free survival (PFS) and overall survival (OS) in a variety of cancers; however, no study has evaluated their clinical significance in esophageal cancer (EC). Methods To examine this significance, we ran a 2 year prospective pilot study consisting of newly diagnosed stage I-III EC patients (n = 32) receiving chemoradiotherapy (CRT). CAML sizes were sequentially monitored prior to CRT (BL), ~ 2 weeks into treatment (T1), and at the first available sample after the completion of CRT (T2). Results We found CAMLs in 88% (n = 28/32) of all patient samples throughout the trial, with a sensitivity of 76% (n = 22/29) in pre-treatment screening samples. Improved 2 year PFS and OS was found in patients with CAMLs < 50 μm by the completion of CRT over patients with CAMLs ≥ 50 μm; PFS (HR = 12.0, 95% CI = 2.7–54.1, p = 0.004) and OS (HR = 9.0, 95%CI = 1.9–43.5, p = 0.019). Conclusions Tracking CAML sizes throughout CRT as a minimally invasive biomarker may serve as a prognostic tool in mapping EC progression, and further studies are warranted to determine if presence of these cells prior to treatment suggest diagnostic value for at-risk populations.