ArticleFrontiers in oncology2026
Case Report: E-cadherin and Vimentin expression in advanced-stage pancreatic ductal adenocarcinoma tissue and circulating tumor cells: preliminary results from a pilot study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis due to late diagnosis and early metastasis. The lack of robust biomarkers necessitates new strategies to stratify high-risk patients. Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is the gold standard for tissue acquisition. Concurrently, circulating tumor cells (CTCs) offer a non-invasive tool for prognostic assessment, specifically regarding the epithelial-to-mesenchymal transition (EMT). The loss of E-cadherin and the expression of Vimentin are key hallmarks of this transition, facilitating a metastatic phenotype and CTC survival. Aim and objectives: This retrospective, preliminary pilot study of 11 patients with advanced PDAC at onset aimed to investigate the expression of EMT markers in EUS-FNB tissue biopsies. Concurrently, we characterized EMT profiles across isolated PDAC CTCs comprising -CD45 Methods: EUS-FNB was performed for histological diagnosis and IHC analysis of E-cadherin and Vimentin in 11 PDAC samples (grade G1-G3). Concurrently, CTC subpopulations were isolated via immunomagnetic CD45 depletion and EpCAM/CD74 enrichment. E-cadherin and Vimentin transcript levels in CTCs were then quantified using real-time PCR. Results: Among the 11 PDAC EUS-FNB biopsies, E-cadherin expression was absent in three cases, all of which were G3 tumors. The majority of samples (72.7%) exhibited low-to-moderate E-cadherin positivity. Regarding Vimentin, biopsies were generally negative, with the exception of small tumor cell clusters (<5%) identified in G3 samples. In contrast, E-cadherin transcripts were not detected in the corresponding CTC subpopulations. Vimentin expression was observed in the majority of CTC samples (81.8%), with nine cases showing moderate-to-high levels and the remaining two cases exhibiting faint expression. Conclusions: Our assay demonstrated a potentially favorable performance, highlighting distinct EMT expression between the primary tumor and CTCs. This baseline comparison of EMT markers in matched PDAC samples and CTCs underscores the significance of mesenchymal-invasive profiles, despite the limited cohort size.
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