循环肿瘤细胞在肺静脉和外周动脉中为非小细胞肺癌患者的 PD-L1 诊断和预后提供了一种衡量标准。
Circulating tumor cells in pulmonary vein and peripheral arterial provide a metric for PD-L1 diagnosis and prognosis of patients with non-small cell lung cancer.
机构信息
Department of Lung Cancer Center, Sichuan University West China Hospital, Chengdu, China.
Department of Otorhinolaryngology, Head & Neck Surgery, Sichuan University West China Hospital, Chengdu, China.
出版信息
PLoS One. 2019 Jul 26;14(7):e0220306. doi: 10.1371/journal.pone.0220306. eCollection 2019.
BACKGROUND
Lung cancer is the leading cause of death caused by malignant tumors. PD-L1(programmed cell death protein-1) has shown tremendous achievement in treating NSCLC. We sought to find the relationship between CTCs in the pulmonary vein and postoperative PFS, besides we detected PD-L1 in CTCs.
METHOD
We enrolled 112 NSCLC patients. CTC tests were performed at four time points (preoperative, pulmonary vein, intraoperative and postoperative) on every NSCLC patient who received surgery. The RNA of PD-L1 was tested by FISH. The levels of the PD-L1 mRNA and protein in tissue samples were detected.
RESULTS
The CTCs in the PV were the highest (P< 0.001), and CTCs in the PPA were the lowest (P< 0.001). The PFS in the group with PV CTCs≥ 16/5 ml was shorter than that in the group with PV CTCs< 16/5 ml (11.1 months vs 21.2 months, respectively; P< 0.001). The PFS in the group with PPA CTCs≥ 3/5 ml was shorter than that in the group with CTCs< 3/5 ml (14.8 months vs 20.7 months, respectively; P< 0.001). The CTCs in stage I were lower than those in stage II-IV (P = 0.025). No linear relationship was found between the CTCs and tumor size (P> 0.05) or LN metastasis (P> 0.05). In total, fifty-two (50.5%) patients had positive PD-L1 expression in CTC. In PD-L1-positive CTC patients, the value of PD-L1 tissue expression was higher than that in PD-L1-negative CTC patients (P = 0.0153).
CONCLUSION
CTCs in the pulmonary vein can be an effective prognosis indicator of NSCLC patients.
背景
肺癌是恶性肿瘤导致死亡的主要原因。PD-L1（程序性死亡蛋白-1）在治疗 NSCLC 方面取得了巨大成就。我们试图找到肺静脉中的 CTC 与术后无进展生存期（PFS）之间的关系，此外我们还检测了 CTC 中的 PD-L1。
方法
我们纳入了 112 名 NSCLC 患者。每位接受手术的 NSCLC 患者在四个时间点（术前、肺静脉、术中、术后）进行 CTC 检测。通过 FISH 检测 PD-L1 的 RNA。检测组织样本中 PD-L1 mRNA 和蛋白的水平。
结果
PV 中的 CTC 最高（P<0.001），PPA 中的 CTC 最低（P<0.001）。PV CTCs≥16/5ml 的患者的 PFS 短于 PV CTCs<16/5ml 的患者（分别为 11.1 个月和 21.2 个月，P<0.001）。PPA CTCs≥3/5ml 的患者的 PFS 短于 CTCs<3/5ml 的患者（分别为 14.8 个月和 20.7 个月，P<0.001）。I 期患者的 CTC 低于 II-IV 期患者（P=0.025）。CTC 与肿瘤大小（P>0.05）或 LN 转移（P>0.05）之间没有线性关系。总共有 52 名（50.5%）患者的 CTC 存在 PD-L1 阳性表达。在 PD-L1 阳性 CTC 患者中，PD-L1 组织表达值高于 PD-L1 阴性 CTC 患者（P=0.0153）。
结论
肺静脉中的 CTC 可以作为 NSCLC 患者的有效预后指标。
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