Fig. 3

Fluctuation of CTC levels in Met-pa receiving chemotherapy. a Scatter dot plot represents the CTC levels in Met-pa with a spectrum of cancer types (median ± range, N = 48 from 48 patients). b Immunofluorescent photomicrograph of CTCs isolated from 2 patients with metastatic rectal and lung cancer (CD45 is red, cytokeratin is green and DAPI is blue). Scale bar is 40 μm. c Stack column charts represent the percentage of CTCs displaying epithelial (E) and both (E/M) phenotypes across cancer type (mean, N = 24 from 12 patients). d Box and whisker charts display the fold change in CTC levels after chemotherapy (median ± range, N = 83 from 30 patients). Significance increase of CTC counts (**P = 0.0047 and *P = 0.0103) after chemotherapy was calculated using a Wilcoxon test. e Box and whisker plots display the CTC levels at baseline in patients with different outcomes (death 1–12 months, disease progression but alive at 12 months, stable disease at 12 months) (median ± range, N = 48 from 48 patients). CTC levels were not significantly different (P = 0.3143) between the death within 1–12 months and stable disease groups, as calculated with a Kruskal-Wallis test. f Survival curve displays the overall survival percentage of Met-pa based on the initial CTC level. The mean value of CTC counts was used for the survival curve (N = 48 from 48 patients). Non-significant effect of CTC counts (P = 0.4492) in predicting the survival probability for Met-pa was determined using a Log-rank (Mantel-Cox) test. g Immunofluorescence photomicrograph of CTCs isolated from a patient with metastatic colon cancer before, after 1 cycle and 2 cycles of antimetabolite-based chemotherapy (CD45 is red, cytokeratin is green and DAPI is blue). Scale bar is 40 μm