Survivin-positive circulating tumor cells as a marker for metastasis of hepatocellular carcinoma

Figure 10  Survivin-positive circulating tumor cells detected during follow-up predict recurrence (m). A and B: Images of two hepatocellular cancer (HCC) patients at the same BCLC stage who expressed survivin in circulating tumor cells (CTCs). At 4 and 5 mo after treatment, the HCC tumors showed more rapid progression in patients with higher survivin expression in CTCs at baseline; C: Cumulative total CTC count by three cell types and survivin-positive CTC count in the two patients before and after operation. The patients’ CTC and survivin-positive CTC count increased at the 2-mo follow-up. Letter E represents epithelial CTCs; Letter H represents hybrid CTCs; Letter M represents mesenchymal CTCs. CTC: Circulating tumor cell.