Evaluation of epithelial-mesenchymal transitioned circulating tumor cells in patients with resectable gastric cancer: Relevance to therapy response

Figure 1 Circulating tumor cells were detected in 35 (79. 5%) patients from gastric cancer group. The average number of circulating tumor cells (CTCs) was 7.25 in the group. CTCs were not observed in any samples from healthy volunteers.

Figure 2 RNA-in situ hybridization analysis of epithelial-to-mesenchymal transition markers in human gastric tumors. The probes were constructed as described in the method section. Representative RNA-in situ hybridization analysis of pooled epithelial (E) (red dots, arrowheads) and mesenchymal (M) (green dots, arrows) markers in (A) primary tumor and (B) tumor-infiltrated lymph node of a patient with gastric cancer. Scale bars: (A) to (B), 20 mm; inserts, 10 mm.

Figure 3 RNA-in situ hybridization analysis of epithelial-to-mesenchymal transition markers in circulating tumor cells from patients with gastric cancer. A: Representative images of five types of CTCs isolated from patients with gastric cancer, based on RNA-ISH staining of E (red dots) and M (green dots) markers. Scale bar, 5 μm; B: Quantitation of EMT features in CTCs based on E and M RNA-ISH staining of histological subtypes of gastric cancer (SRCC and Adenocarcinoma), along with molecular classification of primary tumors (Her2^- and Her2⁺). CTC numbers per 10 mL of blood are listed below. RNA-ISH: RNA-in situ hybridization; CTCs: Circulating tumor cells; E: Epithelial; M: Mesenchymal; EMT: Epithelial-to-mesenchymal transition; DAPI: 4’,6-diamidino-2-phenylindole.

Figure 4 Longitudinal monitoring of epithelial-to-mesenchymal transition features in circulating tumor cells from a patient with resectable gastric cancer following surgery and adjuvant chemotherapy. CTC: Circulating tumor cell; E: Epithelial; M: Mesenchymal.

Figure 5 Regression analysis of the number of observed tumor cells vs the number of expected tumor cells produced a correlation coefficient (R²) of 0. 999. Even a single cell spiked into the samples was detected using this system. CTC: Circulating tumor cell.