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BioMed Research International
Volume 2014, Article ID 981261, 7 pages
Research Article

Stem Cell-Like Circulating Tumor Cells Indicate Poor Prognosis in Gastric Cancer

1Department of Digestive, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
2Tianjin Children Hospital, Tianjin 300074, China

Received 22 April 2014; Revised 11 May 2014; Accepted 12 May 2014; Published 22 May 2014

Academic Editor: Shiwu Zhang

Copyright © 2014 Man Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Circulating tumor cells (CTCs), which have stem cell-like characteristics, might play a crucial role in cancer metastasis. CD44 has been identified as gastric cancer (GC) stem cell (CSC) marker. Here, the prognostic significance of CD44-positive CTCs in GC patients was investigated. CTCs were detected in 27 of 45 GC patients. The presence of CTCs was significantly associated with lymph node metastasis, distant metastasis, and recurrence (, , and , resp.). Nineteen of the 27 CTC-positive patients had CD44-positive CTCs. These patients were more likely to develop metastasis and recurrence than patients with CD44-negative CTCs. CD44-positive CTC counts were higher in recurrent patients than in the nonrecurrent ones (means 4.8 and 1.9, resp.; ). Furthermore, 13 of 19 patients with CD44-positive CTCs developed recurrent disease, and the mean time to recurrence was shorter than that in patients with CD44-negative CTCs ( and months, resp.; ). COX proportional hazards model indicated that the presence of CD44-positive CTCs and TNM stage were independent predictors of recurrence for GC ( and 0.008). So identifying the stem cell-like CTC subset may provide more clinically useful prognostic information than only detecting CTCs.