# Evaluating metastatic risk in breast cancer through CTCs and L1CAM expression

## TL;DR

This study explores how circulating tumor cells and L1CAM can predict breast cancer metastasis, offering a new blood-based approach for evaluating cancer risk.

## Contribution

The study introduces a nomogram combining H-CTCs, L1CAM, and Ki-67 for accurate metastatic risk prediction in breast cancer.

## Key findings

- Hybrid CTCs and L1CAM-positive CTCs are significantly correlated with lymph node metastasis and Ki-67 expression.
- A nomogram integrating H-CTCs, L1CAM, and Ki-67 achieved high accuracy (AUC = 0.98) in predicting metastatic risk.
- Combined detection of H-CTCs and L1CAM enhances preoperative prediction of lymph node metastasis in breast cancer.

## Abstract

Circulating tumor cells (CTCs) and L1 cell adhesion molecule (L1CAM) are associated with breast cancer (BC) metastasis. This study investigated their potential as predictive biomarkers for lymph node metastasis in early-stage invasive breast cancer (ESIBC).

Ninety-three ESIBC patients were enrolled. CTC phenotypes and L1CAM expression were detected in preoperative blood samples using the CanPatrol® CTC system and RNA-ISH. Associations with clinicopathological variables were analyzed.

CTCs were detected in 79.6% of patients. Hybrid CTCs (H-CTCs) and L1CAM-positive CTCs were significantly correlated with lymph node metastasis and Ki-67 expression. A nomogram integrating H-CTCs, L1CAM, and Ki-67 predicted metastatic risk with excellent accuracy (AUC = 0.98).

H-CTCs and L1CAM-positive CTCs serve as potential blood-based biomarkers for evaluating metastatic risk in BC.

The combined detection of H-CTCs and L1CAM enhances preoperative prediction of lymph node metastasis and provides new insights into BC metastasis mechanisms.

Schematic representation of a liquid biopsy strategy for evaluating metastatic risk in BC based on CTC subtypes and L1CAM expression.Diagram depicting a study of early invasive breast cancer in ninety-three patients. It illustrates the use of the CanPatrol circulating tumor cell detection system via blood samples. Key components include Ki-67 detection and analysis of H-CTCs, M-CTCs, and E-CTCs, with a focus on L1CAM. The image features a nomogram, ROC curve, and outlines a liquid biopsy-based risk assessment strategy for breast cancer lymph node metastasis.

Schematic representation of a liquid biopsy strategy for evaluating metastatic risk in BC based on CTC subtypes and L1CAM expression.