Aneuploid circulating endothelial cells with prognostic value in locally advanced breast cancer patients after neoadjuvant chemotherapy

Background: Aneuploid circulating endothelial cells (CECs) are an indicator in breast cancer (BC). Significant changes of aneuploid CECs occurred during neoadjuvant chemotherapy (NCT). The aim of this study was to explore the predictive and prognostic value of aneuploid CECs in locally advanced breast cancer (LABC) patients with different NCT responses. Methods: : Breast cancer patients received an EC4-T4 NCT regimen. A novel subtraction enrichment and immunostaining fluorescence in situ hybridization (SE-iFISH) strategy was applied for detection of CECs (CD45–/CD31+/DAPI+). Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of aneuploid CEC counts in distinguishing NCT-resistant patients from sensitive ones. All patients were observed for progression-free survival (PFS) and overall survival (OS). Results: : The CEC counts at any time point did not show the ability to predict the efficacy of NCT. The difference of the CECs between post-chemotherapy level and baseline could be sufficient to distinguish chemotherapy-resistant cases from other cases in Hormone+Her-2-/+ (HR+) BC patients. Patients with reduction of CECs after all courses of NCT were associated with higher probability of PFS. Conclusion: Variation of aneuploid CECs during NCT may have some ability to predict chemotherapy response in patients with HR+ breast cancer. The decrease of aneuploid CECs number after all courses of NCT indicate better treatment outcomes in LABC patients.