Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Genetics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Cell Oncol (Dordr). 2020 Feb;43(1):31-49. doi: 10.1007/s13402-019-00470-y. Epub 2019 Dec 11.
Lung cancer is the second most common cancer and the main cause of cancer-related mortality worldwide. In spite of various efforts that have been made to facilitate the early diagnosis of lung cancer, most patients are diagnosed when the disease is already in stage IV, which is generally associated with the occurrence of distant metastases and a poor survival. Moreover, a large proportion of these patients will relapse after treatment, heralding the need for the stratification of lung cancer patients in addition to identifying those who are at a higher risk of relapse and, thus, require alternative and/or additional therapies. Recently, circulating tumor cells (CTCs) have been considered as valuable markers for the early diagnosis, prognosis and risk stratification of cancer patients, and they have been found to be able to predict the survival of patients with various types of cancer, including lung cancer. Additionally, the characterization of CTCs has recently provided fascinating insights into the heterogeneity of tumors, which may be instrumental for the development of novel targeted therapies.
Here we review our current understanding of the significance of CTCs in lung cancer metastasis. We also discuss prominent studies reporting the utility of enumeration and characterization of CTCs in lung cancer patients as prognostic and pharmacodynamic biomarkers for those who are at a higher risk of metastasis and drug resistance.
肺癌是全球第二大常见癌症和癌症相关死亡的主要原因。尽管为促进肺癌的早期诊断做出了各种努力，但大多数患者在疾病已处于 IV 期时才被诊断出来，此时通常与远处转移的发生和较差的生存相关。此外，这些患者中的很大一部分在治疗后会复发，这表明除了识别那些复发风险较高的患者外，还需要对肺癌患者进行分层，因此需要替代和/或额外的治疗。最近，循环肿瘤细胞（CTC）被认为是癌症患者早期诊断、预后和风险分层的有价值的标志物，它们已被发现能够预测包括肺癌在内的多种癌症患者的生存情况。此外，CTC 的特征分析最近为肿瘤的异质性提供了引人入胜的见解，这可能对开发新的靶向治疗方法有帮助。
在这里，我们回顾了我们目前对 CTC 在肺癌转移中的重要性的理解。我们还讨论了一些突出的研究报告，这些研究报告了在肺癌患者中对 CTC 的计数和特征分析作为预后和药效学生物标志物的效用，这些标志物可用于预测那些具有较高转移和耐药风险的患者。
