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Objective:Although circulating tumor cells (CTCs) have been well-established as promising prognostic biomarkers in both early breast cancer and metastatic settings,little is known regarding the prognostic relevance of CTCs in the long-term postoperative monitoring of patients with non-metastatic breast cancer (non-MBC).In this study,we investigated the associations of CTCs with clinicopathological features and metabolic-related variables,such as obesity and hyperglycemia.Methods:In this retrospective study,we recruited 264 patients with postoperative stage Ⅰ-Ⅲ breast cancer at Guangdong General Hospital from January 2009 to December 2015.The prevalence and number of CTCs were assessed using the CellSearch System at a median rime of 19.0 months [interquartile range (IQR),7.8-33.0] after surgery.The CTC assay results were correlated with the clinicopathological features and metabolic-related variables.A multivariate logistic regression analysis was performed to further determine the independent predictors of CTCs.Results:CTCs were detected in 10.6％ of all patients.The positive rate of CTCs in patients with infiltrating ductal carcinoma was lower than that in patients with other pathological types (9.0％ vs.28.6％,P=0.020).More importandy,the presence of CTCs was correlated with blood glucose level (P=0.015) and high-density lipoprotein level (P=0.030).The multivariate logistic regression analysis showed that the pathological type [odds ratio (OR):1.757,95％ CI:1.021-3.023;P=0.042] and blood glucose level (OR:1.218,95％ CI:1.014-1.465;P=0.035) were independent predictors of the presence of CTCs.Conclusions:This study revealed potential associations between CTCs and metabolic-related factors in Chinese patients with non-MBC and supports the hypothesis that metabolic dysfunction in breast cancer patients might influence the biological activity of metastatic breast cancer,leading to a higher prevalence of CTCs.