Okumura Yoshitomo, Tanaka Fumihiro, Yoneda Kazue, Hashimoto Masaki, Takuwa Teruhisa, Kondo Nobuyuki, Hasegawa Seiki
Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Ann Thorac Surg. 2009 Jun;87(6):1669-75. doi: 10.1016/j.athoracsur.2009.03.073.
Circulating tumor cells in peripheral blood (CTC) is a potential surrogate of distant metastasis, which is the critical factor influencing decision making regarding therapy and prognosis of primary lung cancer patients. After our preliminary study showing that CTCs were detected in peripheral blood in 29.4% of resectable lung cancer patients, we conducted a prospective study on CTC in pulmonary vein (PV) blood because tumor cells apart from the primary tumor may circulate after passing through the drainage PV.
A total of 30 consecutive lung cancer patients who underwent thoracotomy were included. The CTCs in peripheral blood and in PV blood from the primary tumor site were quantitatively examined with the CellSearch system, and the numbers of CTCs per 7.5 mL peripheral and PV blood in each patient were represented as periCTC count and pvCTC count, respectively.
Circulating tumor cell was detected in peripheral blood in 5 patients (16.7%; the periCTC count was 1 in 2 patients; and 2, 3, and 16 in 1 patient each), and the incidence of positive periCTC was higher in squamous carcinoma patients than in adenocarcinoma patients (p = 0.028). Circulating tumor cell was detected in PV blood in most patients (29 of 30, 96.7%), and the mean and median pvCTC counts were 1,195 and 81, respectively (range, 0 to 10,034). There was no significant correlation between pvCTC count and any other patient characteristic, including periCTC count.
In resectable lung cancer, CTC was positive in peripheral blood of some patients and in PV blood of most patients. A long-term follow-up study to clarify the clinical significance of pvCTC status is warranted.
外周血循环肿瘤细胞（CTC）是远处转移的潜在替代指标，而远处转移是影响原发性肺癌患者治疗决策和预后的关键因素。在我们的初步研究显示29.4%的可切除肺癌患者外周血中可检测到CTC后，我们对肺静脉（PV）血中的CTC进行了一项前瞻性研究，因为除原发肿瘤外的肿瘤细胞可能在通过引流PV后发生循环。
纳入30例连续接受开胸手术的肺癌患者。使用CellSearch系统对外周血和来自原发肿瘤部位的PV血中的CTC进行定量检测，每位患者每7.5 mL外周血和PV血中的CTC数量分别表示为外周CTC计数和PV CTC计数。
5例患者外周血中检测到循环肿瘤细胞（16.7%；2例患者外周CTC计数为1；1例患者外周CTC计数分别为2、3和16），鳞状细胞癌患者外周CTC阳性发生率高于腺癌患者（p = 0.028）。大多数患者（30例中的29例，96.7%）的PV血中检测到循环肿瘤细胞，PV CTC计数的平均值和中位数分别为1195和81（范围，0至10034）。PV CTC计数与任何其他患者特征（包括外周CTC计数）之间均无显著相关性。
在可切除肺癌中，部分患者外周血中CTC呈阳性，大多数患者PV血中CTC呈阳性。有必要进行长期随访研究以阐明PV CTC状态的临床意义。
