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.
PLoS One. 2019 Jul 26;14(7):e0220306. doi: 10.1371/journal.pone.0220306. eCollection 2019.
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.
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.
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).
CTCs in the pulmonary vein can be an effective prognosis indicator of NSCLC patients.
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。
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。
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）。
肺静脉中的 CTC 可以作为 NSCLC 患者的有效预后指标。
