Breast cancer is a widely occurring malignancy, distinguished by intricate modifications in cellular signaling pathways, with epithelial–mesenchymal transition (EMT) recognized as a pivotal mechanism that propels its pathogenesis. EMT significantly facilitates the invasion and metastasis of tumor cells and profoundly affects patient prognosis. This research aims to clarify the relationship between 3 distinct types of circulating tumor cells (CTCs)—epithelial, hybrid, and mesenchymal—their EMT status, and the associated clinical and pathological features in breast cancer patients. A cohort of 48 breast cancer patients was enrolled, utilizing CanPatrol technology to isolate and classify CTCs from peripheral blood samples. Comprehensive multiplex mRNA in situ detection was employed, utilizing various molecular markers for accurate identification. Statistical analyses, including Mann–Whitney U test, chi-square test, and Fisher exact test, were conducted to evaluate the correlations between CTC quantities, EMT ratios, and clinical parameters. Our results demonstrated significant differences in mesenchymal-CTC counts across gender and age demographics ( P = .008, P = .004), alongside notable discrepancies in EMT ratios correlated with Ki-67 expression levels and breast cancer subtypes ( P = .035, P = .048). The EMT ratio was significantly higher in triple-negative breast cancer compared to non-triple-negative variants, with a positive association established between Ki-67 levels and EMT ratios. In conclusion, the EMT ratio of CTCs emerges as a strong predictor of Ki-67 levels and serves as a potential biomarker for triple-negative breast cancer, necessitating further investigation in subsequent studies to enhance prognostic evaluations and therapeutic approaches.
Guan et al. (2025) studied this question.