Fanelli Marcello Ferretti, Oliveira Thiago Bueno, Braun Alexcia Camila, Corassa Marcelo, Abdallah Emne Ali, Nicolau Ulisses Ribaldo, da Silva Alves Vanessa, Garcia Daniel, Calsavara Vinicius F, Kowalski Luiz Paulo, Chinen Ludmilla Thomé Domingos
Department of Medical Oncology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
International Research Center, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
Head Neck. 2017 Nov;39(11):2283-2292. doi: 10.1002/hed.24899. Epub 2017 Aug 17.
Circulating tumor microemboli (CTM) are clusters of circulating tumor cells (CTCs), involved in metastasis, as also transforming growth factor-β (TGF-β). The purpose of this study was to verify their role in progression-free survival (PFS).
Blood from patients with locally advanced head and neck squamous cell carcinoma (HNSCC; n = 53) was analyzed in 2 moments. TGF-β receptor I (TGF-βRI) expression was evaluated by immunocytochemistry.
Comparing CTM1 (baseline) with CTM2 (first follow-up), patients with CTM1-positive disease who became CTM2-negative were classified as favorable (PFS 20 months). Patients with unfavorable evolution (CTM1-negative/CTM2-positive), had PFS of 17.5 months. Patients always CTM-negative showed PFS of 22.4 months, those always positive, 4.7 months (P < .001). The TGF-βRI expression in the first follow-up correlated with poor PFS (12 × 26 months; P = .007), being an independent prognostic factor (hazard ratio [HR] = 6.088; P = .033).
CTM1/2, TGF-βRI expression, and unfavorable CTM kinetics may represent poor prognosis in locally advanced HNSCC.
循环肿瘤微栓子（CTM）是循环肿瘤细胞（CTC）的簇集，参与转移，转化生长因子-β（TGF-β）也参与其中。本研究的目的是验证它们在无进展生存期（PFS）中的作用。
对局部晚期头颈部鳞状细胞癌（HNSCC；n = 53）患者的血液在两个时间点进行分析。通过免疫细胞化学评估TGF-β受体I（TGF-βRI）的表达。
将CTM1（基线）与CTM2（首次随访）进行比较，CTM1阳性疾病且变为CTM2阴性的患者被归类为预后良好（PFS为20个月）。病情进展不利的患者（CTM1阴性/CTM2阳性），PFS为17.5个月。始终CTM阴性的患者PFS为22.4个月，始终阳性的患者为4.7个月（P <.001）。首次随访时TGF-βRI的表达与不良PFS相关（12×26个月；P = .007），是一个独立的预后因素（风险比[HR] = 6.088；P = .033）。
CTM1/2、TGF-βRI表达和不利的CTM动力学可能代表局部晚期HNSCC的预后不良。
