Detection of circulating tumor cells in high-risk endometrial cancer

Aim: To evaluate the presence of circulating tumor cells (CTCs) in patients with high-risk endometrial cancer (EC). Patients and Methods: We prospectively included 28 patients with a preoperative diagnosis of grade 3 EC undergoing surgery from June 2010 to December 2011. Their preoperative blood samples were tested for the presence of CTCs using an immunomagnetic and immunofluorescence assay technique. Results: Overall, 2 out of 28 patients (7%) were positive for CTCs. The presence of positive CTCs was significantly associated with myometrial invasion (MI) (33% vs. 0% for MI >50% vs. ≤50%; p=0.04) and lymph node positivity (40% vs. 0% for positive vs. negative nodes; p=0.03). Only patients with endometrioid histology had positive CTCs (29% in endometrioid vs. 0% in nonendometrioid; p=0.06). Conclusion: The presence of positive CTCs was associated with deep MI and lymph node positivity. The absence of CTCs in patients with type II histology suggests the need to find other markers in this subgroup of patients.