EpCam-positive tumor cells in circulating blood and ascites in ovarian cancer risk assessment

Abstract

Aim: To study the role of EpCam-positive tumor cells in circulating blood and ascites in ovarian cancer risk assessment. Methods. The study included 42 patients with ovarian cancer stages I-IV according to FIGO and 11 patients with benign ovarian tumors. Cells of the mononuclear fraction of the blood and ascites were stained with monoclonal antibodies to CD45, EpCam (CD326), cytokeratin 18. The counting of tumor cells EpCam+CD45-, EpCam+CK18+, EpCam+CD45+ was performed by flow cytometry with a double fluorescent label on a BioSino device (China). The level of CA-125 and Не4 was determined by ELISA. Statistical processing was performed using Statistica 13.0, Jamovi 2.4.14. Results. With the progression of ovarian cancer, the presence of ascites, metastases and relapses of the disease, the number of tumor cells of the EpCam+CK18+ phenotype in the circulating blood increases. A strong relationship was found between the number of EpCam+CK18+ tumor cells and the concentration of tumor markers CA-125 and Не4. In ascites, the number of EpCam+CD45- cells and atypical/hybrid EpCam+CD45+ cells is significantly higher than in circulating blood. The risk of relapse increases by 1.7 times with an increase in the number of EpCam+CK18+ and by 1.14 times with an increase in the number of EpCam+CD45+ in the blood. Predictive potential in the analysis of progression-free time was present for patients with metastases at stage III-IV ovarian cancer for EpCam+CD45- in ascites and the level of Не4 in the blood. Conclusion. The number of EpCam-positive tumor cells in ascites and circulating blood of patients at different stages of ovarian cancer was studied. The predictive significance of various phenotypes of EpCam+ tumor cells in circulating blood in assessing the risk of progression and the period without progression in ovarian cancer was shown. The obtained data can be used to predict the course of ovarian cancer.