ArticleCancers2026
Enrichment-Free Rare Cell Profiling in Pediatric Osteosarcoma Reveals a Circulating Cell Population Associated with Relapse-Free Survival.
Article in Cancers, 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
backgroundOutcomes for patients with osteosarcoma (OS) presenting with metastases at diagnosis or relapsed remain poor with five-year survival rate of only 20-30%. Risk stratification at diagnosis remains limited, and no validated prognostic liquid biopsy analyte currently exists for this disease. OS lacks the recurring mutational hotspots and epithelial surface markers that underpin liquid biopsy strategies developed for carcinomas, necessitating fundamentally different approaches to circulating biomarker detection.
methodsPeripheral blood samples from 25 pediatric and young adult OS patients at clinically apparent disease timepoints (
resultsRare cells were detected at a median of approximately 127 cells/mL (range: 29-1114) in OS patients at clinically apparent disease timepoints versus 34 cells/mL (range: 4-225) in healthy donors. DAPI-only (D) cells, identified using a data-driven optimal cutpoint (38.32 cells/mL) that is subject to optimization bias and requires independent validation, were associated with relapse-free survival in this exploratory, single-center OS cohort (log-rank
conclusionsEnrichment-free rare cell profiling identifies a DAPI-only circulating rare cell population whose abundance is associated with relapse-free survival in this exploratory, single-center OS cohort, accessible by nuclear morphology alone without biomarker enrichment. This is a novel, hypothesis-generating observation that, together with the mesenchymal-forward D|V population characterized here, motivates a larger, independent, prospective validation cohort and dedicated single-cell molecular (proteomic) characterization of the D-cell population, rather than establishing DAPI-only rare cell enumeration as a validated liquid biopsy stratification tool at this stage.
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