Chang Pei-Hung, Wu Min-Hsien, Liu Sen-Yu, Wang Hung-Ming, Huang Wen-Kuan, Liao Chun-Ta, Yen Tzu-Chen, Ng Shu-Hang, Chen Jen-Shi, Lin Yung-Chang, Lin Hung-Chih, Hsieh Jason Chia-Hsun
Chang Gung University, College of Medicine, Taoyuan 333, Taiwan.
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 20401, Taiwan.
Cancers (Basel). 2019 Apr 15;11(4):540. doi: 10.3390/cancers11040540.
Circulating tumor cells (CTCs) and immune status are strongly related to cancer prognosis, although few studies have examined both factors. This prospective observational study (ClinicalTrials.gov: NCT02420600) evaluated whether CTCs, circulating cancer stem-like cells (cCSCs), and peripheral lymphocytes with/without Programmed cell death protein 1 (PD-1) expression were associated with prognosis among patients receiving palliative chemotherapy for initially unresectable, recurrent/metastatic head and neck squamous cell carcinoma (rmHNSCC). Thirty-four patients were enrolled between January 2015 and June 2016. Overall survival (OS) was associated with a higher CTC number (hazard ratio [HR]: 1.01, = 0.0004) and cCSC ratio (HR: 29.903, < 0.0001). Progression-free survival (PFS) was also associated with CTC number (HR: 1.013, = 0.002) and cCSC ratio (HR: 10.92, = 0.003). A CD8⁺ proportion of ≥ 17% was associated with improved OS (HR: 0.242, = 0.004). A CD4: CD8 ratio of >1.2 was associated with poorer trend of PFS (HR: 2.12, = 0.064). PD-1 expression was not associated with survival outcomes. Baseline CTCs, cCSC ratio, and CD8⁺ ratio may predict prognosis in rmHNSCC.
循环肿瘤细胞（CTCs）与免疫状态和癌症预后密切相关，尽管很少有研究同时考察这两个因素。这项前瞻性观察性研究（ClinicalTrials.gov：NCT02420600）评估了对于初始不可切除、复发/转移性头颈部鳞状细胞癌（rmHNSCC）接受姑息化疗的患者，CTCs、循环癌干细胞样细胞（cCSCs）以及有/无程序性细胞死亡蛋白1（PD-1）表达的外周淋巴细胞是否与预后相关。2015年1月至2016年6月期间招募了34例患者。总生存期（OS）与较高的CTCs数量（风险比[HR]：1.01， = 0.0004）和cCSCs比例（HR：29.903， < 0.0001）相关。无进展生存期（PFS）也与CTCs数量（HR：1.013， = 0.002）和cCSCs比例（HR：10.92， = 0.003）相关。CD8⁺比例≥17%与改善的OS相关（HR：0.242， = 0.004）。CD4:CD8比例>1.2与PFS较差的趋势相关（HR：2.12， = 0.064）。PD-1表达与生存结果无关。基线CTCs、cCSCs比例和CD8⁺比例可能预测rmHNSCC的预后。
