Department of Thoracic Cardiovascular Surgery, Affiliated Suzhou Municipal Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.
PLoS One. 2019 Jul 25;14(7):e0219129. doi: 10.1371/journal.pone.0219129. eCollection 2019.
Circulating tumor cells (CTCs) are an independent prognostic marker in non-small cell lung cancer (NSCLC). CTC numbers are closely related to early diagnosis, clinical stage, therapy surveillance, and prognosis of NSCLC. We used a more efficient nano-enrichment method to detect CTCs in NSCLC patients and explored the clinical value of CTCs. The results showed that CTC numbers in stage IV cases were significantly higher than those in stage I, II or III cases. The number of CTCs in poorly-differentiated cases was significantly higher than that in well-differentiated cases. During six chemotherapy cycles, the average CTC number decreased from 5.8/7.5 ml in cycle #1 to 2.4/7.5 ml in cycle #4 and remained at almost the same level from 4 to 6 cycles. CTC numbers in patients with EGFR mutations was significantly higher than those in patients with no mutations. The average progression free survival (PFS) in the favorable group (CTC ≤ 5/7.5 ml) was 11.3 months, which was longer than that in the unfavorable group (CTC > 5/7.5 ml, 7.2 months). In conclusion, the assessment of NSCLC cannot be performed using a single CTC analysis. The clinical value is more significant in the continuous analysis of CTC data, as well as the cross-validation of other indexes and imaging results.
循环肿瘤细胞（CTCs）是非小细胞肺癌（NSCLC）的独立预后标志物。CTCs 数量与 NSCLC 的早期诊断、临床分期、治疗监测和预后密切相关。我们使用了一种更有效的纳米富集方法来检测 NSCLC 患者的 CTCs，并探讨了 CTCs 的临床价值。结果表明，IV 期患者的 CTC 数量明显高于 I、II 或 III 期患者。低分化病例的 CTC 数量明显高于高分化病例。在六个化疗周期中，CTCs 数量从第 1 周期的 5.8/7.5 ml 平均减少到第 4 周期的 2.4/7.5 ml，从第 4 周期到第 6 周期基本保持在同一水平。EGFR 突变患者的 CTC 数量明显高于无突变患者。CTC 数量良好组（CTC ≤ 5/7.5 ml）的无进展生存期（PFS）平均为 11.3 个月，长于 CTC 数量不良组（CTC > 5/7.5 ml，7.2 个月）。总之，不能仅通过单次 CTC 分析来评估 NSCLC。在连续分析 CTC 数据以及与其他指标和影像学结果的交叉验证方面，其临床价值更为显著。
