Detection and prognostic relevance of circulating tumour cells (CTCs) in Asian breast cancers using a label-free microfluidic platform
We aimed to study the prevalence of CTCs in breast cancer (BC) patients undergoing neoadjuvant or palliative therapy with a label-free microfluidic platform (ClearCell FX), and its prognostic relevance in metastatic BC (mBC). Peripheral blood samples were collected from 108 BC patients before starti...
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| Veröffentlicht in: | PloS one 2019-09, Vol.14 (9), p.e0221305-e0221305 |
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| creator | Yap, Yoon-Sim Leong, Man Chun Chua, Yong Wei Loh, Kiley Wei Jen Lee, Guek Eng Lim, Elaine Hsuen Dent, Rebecca Ng, Raymond Chee Hui Lim, John Heng-Chi Singh, Garima Tan, Angela Guan, Guofeng Wu, Andrew Lee, Yi Fang Bhagat, Ali Asgar S Lim, Darren Wan-Teck |
| description | We aimed to study the prevalence of CTCs in breast cancer (BC) patients undergoing neoadjuvant or palliative therapy with a label-free microfluidic platform (ClearCell FX), and its prognostic relevance in metastatic BC (mBC).
Peripheral blood samples were collected from 108 BC patients before starting a new line of treatment ("baseline"), majority of whom had mBC (76/108; 70.4%). CTCs were retrieved by dean flow fractionation that enriched for larger cells, and enumerated using immunofluorescence-based staining. Progression-free survival (PFS) in mBC patients was analysed using Kaplan-Meier method; cox proportional hazard models were used for univariable and multivariable analyses.
The detection rate of CTCs before starting a new line of treatment was 75.9% (n = 108; median: 8 CTCs/7.5 ml blood) at a cut off of ≥2 CTCs. PFS was inferior for mBC patients with baseline CTC count ≥5 CTCs/7.5 ml blood vs. those with < 5 CTCs/7.5 ml blood (median PFS: 4.3 vs. 7.0 months; p-value: 0.037). The prognostic relevance of CTCs was most significant in patients with HER2- mBC (median PFS: 4.1 vs. 8.3 months; p-value: 0.032), luminal (HR+HER2-) subtype (median PFS: 4.2 vs. 8.3 months; p-value: 0.048), and patients who had one or more prior treatments (median PFS: 4.2 vs. 7.0 months; p-value: 0.02). On multivariable analysis, baseline CTC level (hazard ratio (HR): 1.84, p-value: 0.02) and pre-treatment status (HR: 1.87, p-value: 0.05) were independent predictors of PFS.
This work demonstrates the prognostic significance of CTCs in mBC detected using a label-free size-based enrichment platform. |
| doi_str_mv | 10.1371/journal.pone.0221305 |
| format | Article |
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Peripheral blood samples were collected from 108 BC patients before starting a new line of treatment ("baseline"), majority of whom had mBC (76/108; 70.4%). CTCs were retrieved by dean flow fractionation that enriched for larger cells, and enumerated using immunofluorescence-based staining. Progression-free survival (PFS) in mBC patients was analysed using Kaplan-Meier method; cox proportional hazard models were used for univariable and multivariable analyses.
The detection rate of CTCs before starting a new line of treatment was 75.9% (n = 108; median: 8 CTCs/7.5 ml blood) at a cut off of ≥2 CTCs. PFS was inferior for mBC patients with baseline CTC count ≥5 CTCs/7.5 ml blood vs. those with < 5 CTCs/7.5 ml blood (median PFS: 4.3 vs. 7.0 months; p-value: 0.037). The prognostic relevance of CTCs was most significant in patients with HER2- mBC (median PFS: 4.1 vs. 8.3 months; p-value: 0.032), luminal (HR+HER2-) subtype (median PFS: 4.2 vs. 8.3 months; p-value: 0.048), and patients who had one or more prior treatments (median PFS: 4.2 vs. 7.0 months; p-value: 0.02). On multivariable analysis, baseline CTC level (hazard ratio (HR): 1.84, p-value: 0.02) and pre-treatment status (HR: 1.87, p-value: 0.05) were independent predictors of PFS.
This work demonstrates the prognostic significance of CTCs in mBC detected using a label-free size-based enrichment platform.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0221305</identifier><identifier>PMID: 31553731</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adjuvant chemotherapy ; Adult ; Aged ; Asian Continental Ancestry Group ; Biology and Life Sciences ; Blood ; Breast cancer ; Breast Neoplasms - blood ; Breast Neoplasms - metabolism ; Breast Neoplasms - pathology ; Cancer metastasis ; Cancer research ; Cancer therapies ; Care and treatment ; Cell adhesion & migration ; Cell Count ; Cell survival ; Chemotherapy ; EDTA ; Engineering and Technology ; ErbB-2 protein ; Female ; Fluorescent antibody technique ; Fractionation ; Humans ; Immunofluorescence ; Immunohistochemistry ; Kaplan-Meier Estimate ; Lapatinib ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Metastases ; Metastasis ; Microfluidics ; Middle Aged ; Neoadjuvant therapy ; Neoplastic Cells, Circulating - pathology ; Oncology ; Pathology ; Peripheral blood ; Prognosis ; Progression-Free Survival ; Prospective Studies ; Receptor, ErbB-2 - metabolism ; Risk factors ; Sampling methods ; Singapore ; Statistical models ; Studies ; Tumors</subject><ispartof>PloS one, 2019-09, Vol.14 (9), p.e0221305-e0221305</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Yap et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Yap et al 2019 Yap et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-eaf029a431ff20b957c13e638b5f60c365b4e0ce09ace5e06bba0048395110283</citedby><cites>FETCH-LOGICAL-c593t-eaf029a431ff20b957c13e638b5f60c365b4e0ce09ace5e06bba0048395110283</cites><orcidid>0000-0002-4695-8762 ; 0000-0002-0347-5066</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760773/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760773/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31553731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yap, Yoon-Sim</creatorcontrib><creatorcontrib>Leong, Man Chun</creatorcontrib><creatorcontrib>Chua, Yong Wei</creatorcontrib><creatorcontrib>Loh, Kiley Wei Jen</creatorcontrib><creatorcontrib>Lee, Guek Eng</creatorcontrib><creatorcontrib>Lim, Elaine Hsuen</creatorcontrib><creatorcontrib>Dent, Rebecca</creatorcontrib><creatorcontrib>Ng, Raymond Chee Hui</creatorcontrib><creatorcontrib>Lim, John Heng-Chi</creatorcontrib><creatorcontrib>Singh, Garima</creatorcontrib><creatorcontrib>Tan, Angela</creatorcontrib><creatorcontrib>Guan, Guofeng</creatorcontrib><creatorcontrib>Wu, Andrew</creatorcontrib><creatorcontrib>Lee, Yi Fang</creatorcontrib><creatorcontrib>Bhagat, Ali Asgar S</creatorcontrib><creatorcontrib>Lim, Darren Wan-Teck</creatorcontrib><title>Detection and prognostic relevance of circulating tumour cells (CTCs) in Asian breast cancers using a label-free microfluidic platform</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We aimed to study the prevalence of CTCs in breast cancer (BC) patients undergoing neoadjuvant or palliative therapy with a label-free microfluidic platform (ClearCell FX), and its prognostic relevance in metastatic BC (mBC).
Peripheral blood samples were collected from 108 BC patients before starting a new line of treatment ("baseline"), majority of whom had mBC (76/108; 70.4%). CTCs were retrieved by dean flow fractionation that enriched for larger cells, and enumerated using immunofluorescence-based staining. Progression-free survival (PFS) in mBC patients was analysed using Kaplan-Meier method; cox proportional hazard models were used for univariable and multivariable analyses.
The detection rate of CTCs before starting a new line of treatment was 75.9% (n = 108; median: 8 CTCs/7.5 ml blood) at a cut off of ≥2 CTCs. PFS was inferior for mBC patients with baseline CTC count ≥5 CTCs/7.5 ml blood vs. those with < 5 CTCs/7.5 ml blood (median PFS: 4.3 vs. 7.0 months; p-value: 0.037). The prognostic relevance of CTCs was most significant in patients with HER2- mBC (median PFS: 4.1 vs. 8.3 months; p-value: 0.032), luminal (HR+HER2-) subtype (median PFS: 4.2 vs. 8.3 months; p-value: 0.048), and patients who had one or more prior treatments (median PFS: 4.2 vs. 7.0 months; p-value: 0.02). On multivariable analysis, baseline CTC level (hazard ratio (HR): 1.84, p-value: 0.02) and pre-treatment status (HR: 1.87, p-value: 0.05) were independent predictors of PFS.
This work demonstrates the prognostic significance of CTCs in mBC detected using a label-free size-based enrichment platform.</description><subject>Adjuvant chemotherapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Asian Continental Ancestry Group</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - blood</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer metastasis</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Cell adhesion & migration</subject><subject>Cell Count</subject><subject>Cell survival</subject><subject>Chemotherapy</subject><subject>EDTA</subject><subject>Engineering and Technology</subject><subject>ErbB-2 protein</subject><subject>Female</subject><subject>Fluorescent antibody technique</subject><subject>Fractionation</subject><subject>Humans</subject><subject>Immunofluorescence</subject><subject>Immunohistochemistry</subject><subject>Kaplan-Meier Estimate</subject><subject>Lapatinib</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Microfluidics</subject><subject>Middle Aged</subject><subject>Neoadjuvant therapy</subject><subject>Neoplastic Cells, Circulating - pathology</subject><subject>Oncology</subject><subject>Pathology</subject><subject>Peripheral blood</subject><subject>Prognosis</subject><subject>Progression-Free Survival</subject><subject>Prospective Studies</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Risk factors</subject><subject>Sampling methods</subject><subject>Singapore</subject><subject>Statistical models</subject><subject>Studies</subject><subject>Tumors</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptUstu1DAUjRCIloE_QGCJTVlk8COOk02l0fCqVIlNWVuOcz145NiDnVTiB_hunE5adVDlha3rc859naJ4S_CaMEE-7cMUvXLrQ_CwxpQShvmz4py0jJY1xez5o_dZ8SqlPcacNXX9sjhjhHMmGDkv_n6GEfRog0fK9-gQw86HNFqNIji4VV4DCgZpG_Xk1Gj9Do3TkFMjDc4ldLG92aaPyHq0SVZ51EVQaUR6JsaEpjQzFHKqA1eaCIAGq2MwbrJ9TnLImibE4XXxwiiX4M1yr4qfX7_cbL-X1z--XW0316XmLRtLUAbTVlWMGENx13KhCYOaNR03Ndas5l0FWANulQYOuO46hXHVsJYTgmnDVsX7o-7BhSSXESZJaSsIpYKzjLg6Ivqg9vIQ7aDiHxmUlXeBEHdSxTwfB5JkOKiOUuhFRYCpVlSG6qYVutI6i62KyyXb1A3Qa_BjVO5E9PTH219yF25lLWosxFzMxSIQw-8J0igHm-bBKw9huqu7IRWvGpqhH_6DPt3dgtqp3ID1JuS8ehaVmxpjUTFczVrrJ1D59JC3l_1mbI6fEKojIa82pQjmoUeC5ezW-2Lk7Fa5uDXT3j2ezwPp3p7sH7Ru5_E</recordid><startdate>20190925</startdate><enddate>20190925</enddate><creator>Yap, Yoon-Sim</creator><creator>Leong, Man Chun</creator><creator>Chua, Yong Wei</creator><creator>Loh, Kiley Wei Jen</creator><creator>Lee, Guek Eng</creator><creator>Lim, Elaine Hsuen</creator><creator>Dent, Rebecca</creator><creator>Ng, Raymond Chee Hui</creator><creator>Lim, John Heng-Chi</creator><creator>Singh, Garima</creator><creator>Tan, Angela</creator><creator>Guan, Guofeng</creator><creator>Wu, Andrew</creator><creator>Lee, Yi Fang</creator><creator>Bhagat, Ali Asgar S</creator><creator>Lim, Darren Wan-Teck</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4695-8762</orcidid><orcidid>https://orcid.org/0000-0002-0347-5066</orcidid></search><sort><creationdate>20190925</creationdate><title>Detection and prognostic relevance of circulating tumour cells (CTCs) in Asian breast cancers using a label-free microfluidic platform</title><author>Yap, Yoon-Sim ; Leong, Man Chun ; Chua, Yong Wei ; Loh, Kiley Wei Jen ; Lee, Guek Eng ; Lim, Elaine Hsuen ; Dent, Rebecca ; Ng, Raymond Chee Hui ; Lim, John Heng-Chi ; Singh, Garima ; Tan, Angela ; Guan, Guofeng ; Wu, Andrew ; Lee, Yi Fang ; Bhagat, Ali Asgar S ; Lim, Darren Wan-Teck</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-eaf029a431ff20b957c13e638b5f60c365b4e0ce09ace5e06bba0048395110283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adjuvant chemotherapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Asian Continental Ancestry Group</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - blood</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer metastasis</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Cell adhesion & migration</topic><topic>Cell Count</topic><topic>Cell survival</topic><topic>Chemotherapy</topic><topic>EDTA</topic><topic>Engineering and Technology</topic><topic>ErbB-2 protein</topic><topic>Female</topic><topic>Fluorescent antibody technique</topic><topic>Fractionation</topic><topic>Humans</topic><topic>Immunofluorescence</topic><topic>Immunohistochemistry</topic><topic>Kaplan-Meier Estimate</topic><topic>Lapatinib</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Microfluidics</topic><topic>Middle Aged</topic><topic>Neoadjuvant therapy</topic><topic>Neoplastic Cells, Circulating - pathology</topic><topic>Oncology</topic><topic>Pathology</topic><topic>Peripheral blood</topic><topic>Prognosis</topic><topic>Progression-Free Survival</topic><topic>Prospective Studies</topic><topic>Receptor, ErbB-2 - 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Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yap, Yoon-Sim</au><au>Leong, Man Chun</au><au>Chua, Yong Wei</au><au>Loh, Kiley Wei Jen</au><au>Lee, Guek Eng</au><au>Lim, Elaine Hsuen</au><au>Dent, Rebecca</au><au>Ng, Raymond Chee Hui</au><au>Lim, John Heng-Chi</au><au>Singh, Garima</au><au>Tan, Angela</au><au>Guan, Guofeng</au><au>Wu, Andrew</au><au>Lee, Yi Fang</au><au>Bhagat, Ali Asgar S</au><au>Lim, Darren Wan-Teck</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection and prognostic relevance of circulating tumour cells (CTCs) in Asian breast cancers using a label-free microfluidic platform</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-09-25</date><risdate>2019</risdate><volume>14</volume><issue>9</issue><spage>e0221305</spage><epage>e0221305</epage><pages>e0221305-e0221305</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We aimed to study the prevalence of CTCs in breast cancer (BC) patients undergoing neoadjuvant or palliative therapy with a label-free microfluidic platform (ClearCell FX), and its prognostic relevance in metastatic BC (mBC).
Peripheral blood samples were collected from 108 BC patients before starting a new line of treatment ("baseline"), majority of whom had mBC (76/108; 70.4%). CTCs were retrieved by dean flow fractionation that enriched for larger cells, and enumerated using immunofluorescence-based staining. Progression-free survival (PFS) in mBC patients was analysed using Kaplan-Meier method; cox proportional hazard models were used for univariable and multivariable analyses.
The detection rate of CTCs before starting a new line of treatment was 75.9% (n = 108; median: 8 CTCs/7.5 ml blood) at a cut off of ≥2 CTCs. PFS was inferior for mBC patients with baseline CTC count ≥5 CTCs/7.5 ml blood vs. those with < 5 CTCs/7.5 ml blood (median PFS: 4.3 vs. 7.0 months; p-value: 0.037). The prognostic relevance of CTCs was most significant in patients with HER2- mBC (median PFS: 4.1 vs. 8.3 months; p-value: 0.032), luminal (HR+HER2-) subtype (median PFS: 4.2 vs. 8.3 months; p-value: 0.048), and patients who had one or more prior treatments (median PFS: 4.2 vs. 7.0 months; p-value: 0.02). On multivariable analysis, baseline CTC level (hazard ratio (HR): 1.84, p-value: 0.02) and pre-treatment status (HR: 1.87, p-value: 0.05) were independent predictors of PFS.
This work demonstrates the prognostic significance of CTCs in mBC detected using a label-free size-based enrichment platform.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31553731</pmid><doi>10.1371/journal.pone.0221305</doi><orcidid>https://orcid.org/0000-0002-4695-8762</orcidid><orcidid>https://orcid.org/0000-0002-0347-5066</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-09, Vol.14 (9), p.e0221305-e0221305 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2297122753 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adjuvant chemotherapy Adult Aged Asian Continental Ancestry Group Biology and Life Sciences Blood Breast cancer Breast Neoplasms - blood Breast Neoplasms - metabolism Breast Neoplasms - pathology Cancer metastasis Cancer research Cancer therapies Care and treatment Cell adhesion & migration Cell Count Cell survival Chemotherapy EDTA Engineering and Technology ErbB-2 protein Female Fluorescent antibody technique Fractionation Humans Immunofluorescence Immunohistochemistry Kaplan-Meier Estimate Lapatinib Medical prognosis Medical research Medicine and Health Sciences Metastases Metastasis Microfluidics Middle Aged Neoadjuvant therapy Neoplastic Cells, Circulating - pathology Oncology Pathology Peripheral blood Prognosis Progression-Free Survival Prospective Studies Receptor, ErbB-2 - metabolism Risk factors Sampling methods Singapore Statistical models Studies Tumors |
| title | Detection and prognostic relevance of circulating tumour cells (CTCs) in Asian breast cancers using a label-free microfluidic platform |
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