Gallo Marianna, De Luca Antonella, Maiello Monica Rosaria, D'Alessio Amelia, Esposito Claudia, Chicchinelli Nicoletta, Forgione Laura, Piccirillo Maria Carmela, Rocco Gaetano, Morabito Alessandro, Botti Gerardo, Normanno Nicola
Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-"Fondazione G. Pascale", Naples, Italy.
Clinical Trials Unit, Istituto Nazionale Tumori-IRCCS-"Fondazione G. Pascale", Naples, Italy.
Transl Lung Cancer Res. 2017 Aug;6(4):486-498. doi: 10.21037/tlcr.2017.05.07.
Several different studies have addressed the role of the circulating tumor cells (CTC) in non-small-cell lung cancer (NSCLC). In particular, the potential of CTC analysis in the early diagnosis of NSCLC and in the prediction of the outcome of patients with early and advanced NSCLC have been explored. A major limit of these studies is that they used different techniques for CTC isolation and enumeration, they employed different thresholds to discriminate between high- and low-risk patients, and they enrolled heterogeneous and often small cohort of patients. Nevertheless, the results of many studies are concordant in indicating a correlation between high CTC count and poor prognosis in both early and advanced NSCLC. The reduction of CTC number following treatment might also represent an important indicator of sensitivity to therapy in patients with metastatic disease. Preliminary data also suggest the potential for CTC analysis in the early diagnosis of NSCLC in high-risk individuals. However, these findings need to be confirmed in large prospective trials in order to be transferred to the clinical practice. The molecular profiling of single CTC in NSCLC might provide important information on tumor biology and on the mechanisms involved in tumor dissemination and in acquired resistance to targeted therapies. In this respect, xenografts derived from CTC might represent a valuable tool to investigate these phenomena and to develop novel therapeutic strategies.
几项不同的研究探讨了循环肿瘤细胞（CTC）在非小细胞肺癌（NSCLC）中的作用。特别是，已经探索了CTC分析在NSCLC早期诊断以及早期和晚期NSCLC患者预后预测方面的潜力。这些研究的一个主要局限在于，它们使用了不同的技术进行CTC分离和计数，采用了不同的阈值来区分高风险和低风险患者，并且纳入的患者群体异质性大且往往规模较小。尽管如此，许多研究结果一致表明，在早期和晚期NSCLC中，高CTC计数与不良预后之间存在关联。治疗后CTC数量的减少也可能是转移性疾病患者对治疗敏感性的一个重要指标。初步数据还表明，CTC分析在高危个体NSCLC早期诊断中具有潜力。然而，这些发现需要在大型前瞻性试验中得到证实，以便应用于临床实践。NSCLC中单个CTC的分子谱分析可能提供有关肿瘤生物学以及肿瘤播散和获得性靶向治疗耐药性所涉及机制的重要信息。在这方面，源自CTC的异种移植可能是研究这些现象和开发新治疗策略的有价值工具。
