Distant metastasis is a main cause of death of prostate cancer. How to identify prostate cancer with a high risk of metastasis is of great important in clinical practice. To clarify the significance of circulating tumor cells (CTCs) undergoing epithelial mesenchymal transition (EMT) and CTCs expressing MAP1S in patients with prostate cancer, we used an advanced CanPatrol CTC-enrichment technique and in situ hybridization to enrich and classify CTC from blood samples.

Patients with prostate cancer who were diagnosed by biopsy or postoperation pathology without any anti-tumor treatment were enrolled in study during November 2017 to November 2018. Enrichment of peripheral blood tumor cells was performed using CanPatrolTM CTCs enrichment technique and fluorescence in situ hybridization was performed to detect epithelial and mesenchymal marker and MAP1S expression. The captured circulating tumor cells was divided into epithelial type (expressing epithelial markers only), hybrid type (simultaneous expression of epithelial and mesenchymal markers), and mesenchymal type (expressing mesenchymal markers only) to investigate their relevance to the clinical features of prostate cancer.

A total of 26 patients were included, all patients was CTC positive, 92.30% patients was hybrid CTC positive. Average MAP1S positive CTCs count was 3.50(5.25). Increased MAP1S positive rate was associated with increased distant metastasis risk, and increased hybrid CTCs proportion associated with increased distant metastasis risk and increased Gleason grade.

The EMT process and MAP1s expression rate of CTCs is related to distant metastases of prostate cancer. CTC typing is expecting to employ as an early diagnostic tool for non-invasive diagnosis of prostate cancer metastases.