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tumor cells (CTCs) and\/or circulating tumor microemboli (CTM) from non-small cell lung cancer (NSCLC) patients may be a non-invasive tool for prognosis, acting as liquid biopsy. CTCs interact with platelets through the transforming growth factor-\u03b2\/transforming growth factor-\u03b2 receptor type 1 (TGF-\u03b2\/TGF\u03b2RI) forming clusters. CTCs also may express the Cluster of Differentiation 47 (CD47) protein, responsible for the inhibition of phagocytosis, the \u201cdon\u2019t eat me\u201d signal to macrophages. Objectives: To isolate, quantify and analyze CTCs\/CTMs from metastatic NSCLC patients, identify TGF\u03b2RI\/CD47 expression in CTCs\/CTMs, and correlate with progression-free survival (PFS). Methods: Blood (10 mL) was collected at two time-points: T1 (before the beginning of any line of treatment; T2 (60 days after initial collection). CTCs were isolated using ISET\u00ae. Immunocytochemistry was conducted to evaluate TGF\u03b2RI\/CD47 expression. Results: 45 patients were evaluated. CTCs were observed in 82.2% of patients at T1 (median: 1 CTC\/mL; range: 0.33\u201311.33 CTCs\/mL) and 94.5% at T2 (median: 1.33 CTC\/mL; 0.33\u20139.67). CTMs were observed in 24.5% of patients and significantly associated with poor PFS (10 months vs. 17 months for those without clusters; p = 0.05) and disease progression (p = 0.017). CTMs CD47+ resulted in poor PFS (p = 0.041). TGF\u03b2RI expression in CTCs\/CTMs was not associated with PFS. Conclusion: In this study, we observed that CTC\/CTM from NSCLC patients express the immune evasion markers TGF\u03b2RI\/CD47. The presence of CTMs CD47+ is associated with poor PFS. This was the first study to investigate CD47 expression in CTCs\/CTM of patients with NSCLC and its association with poor PFS.<\/jats:p>","DOI":"10.3390\/ijms241511958","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T01:27:46Z","timestamp":1690421266000},"page":"11958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["CD47 Expression in Circulating Tumor Cells and Circulating Tumor Microemboli from Non-Small Cell Lung Cancer Patients Is a Poor Prognosis Factor"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-3479","authenticated-orcid":false,"given":"Jacqueline Aparecida","family":"Torres","sequence":"first","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Borsarelli Carvalho","family":"Brito","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, A.C. Camargo Cancer Center, S\u00e3o Paulo 01509-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilio Souza e","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, A.C. Camargo Cancer Center, S\u00e3o Paulo 01509-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iara Monique","family":"Messias","sequence":"additional","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-2026","authenticated-orcid":false,"given":"Alexcia Camila","family":"Braun","sequence":"additional","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-6032","authenticated-orcid":false,"given":"Anna Paula Carreta","family":"Ruano","sequence":"additional","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcilei E. C.","family":"Buim","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Mar\u00edlia, S\u00e3o Paulo 17519-030, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirce Maria","family":"Carraro","sequence":"additional","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmilla Thom\u00e9 Domingos","family":"Chinen","sequence":"additional","affiliation":[{"name":"International Research Center, A.C. Camargo Cancer Center, S\u00e3o Paulo 01508-010, Brazil"},{"name":"Translational Medicine Laboratory, N\u00facleo de Pesquisa e Ensino da Rede S\u00e3o Camilo, S\u00e3o Paulo 04014-002, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"ref_1","unstructured":"(2023, April 14). 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