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This study aimed to assess the prognostic role of OCT4<jats:sup>+<\/jats:sup>CTC in advanced cholangiocarcinoma (CCA) patients who received ICI treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In total, 40 advanced CCA patients who received ICI treatment were included, and CTC and OCT4 counts were detected via a Canpatrol system and an RNA in situ hybridization method before ICI treatment. Patients were subsequently divided into none CTC, OCT4<jats:sup>\u2212<\/jats:sup>CTC, and OCT4<jats:sup>+<\/jats:sup>CTC groups. Patients were followed up for a median of 10.4 months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The percentages of patients in none CTC, OCT4<jats:sup>\u2212<\/jats:sup>CTC, and OCT4<jats:sup>+<\/jats:sup>CTC groups were 25.0%, 30.0%, and 45.0%, respectively. The proportion of patients with lymph node metastasis was highest in OCT4<jats:sup>+<\/jats:sup>CTC group, followed by none CTC group, and lowest in OCT4<jats:sup>\u2212<\/jats:sup>CTC group (<jats:italic>P<\/jats:italic>\u2009=\u20090.025). The objective response rate (ORR) was lowest in OCT4<jats:sup>+<\/jats:sup>CTC group, moderate in OCT4<jats:sup>\u2212<\/jats:sup>CTC group, and highest in none CTC group (<jats:italic>P<\/jats:italic>\u2009=\u20090.009), while disease control rate was not different among three groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.293). In addition, progression-free survival (PFS) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and overall survival (OS) (<jats:italic>P<\/jats:italic>\u2009=\u20090.001) were shorter in the OCT4<jats:sup>+<\/jats:sup>CTC group than in none CTC &amp; OCT4<jats:sup>\u2212<\/jats:sup>CTC group. Moreover, OCT4<jats:sup>+<\/jats:sup>CTC (versus none CTC) was independently linked with poorer PFS [hazard ratio (HR)\u2009=\u20096.752, <jats:italic>P<\/jats:italic>\u2009=\u20090.001] and OS (HR\u2009=\u20096.674, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) in advanced CCA patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>OCT4<jats:sup>+<\/jats:sup>CTC relates to lymph node metastasis and shows a good predictive value for poor treatment response and survival in advanced CCA patients who receive ICI treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-024-03369-7","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T09:01:49Z","timestamp":1714035709000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Octamer-binding transcription factor 4-positive circulating tumor cell predicts worse treatment response and survival in advanced cholangiocarcinoma patients who receive immune checkpoint inhibitors treatment"],"prefix":"10.1186","volume":"22","author":[{"given":"Fei","family":"Pei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shasha","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"issue":"1","key":"3369_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1038\/s41572-021-00300-2","volume":"7","author":"PJ Brindley","year":"2021","unstructured":"Brindley PJ, Bachini M, Ilyas SI, et al. 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All patients provided informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"110"}}