循环肿瘤细胞表型与非小细胞肺癌 18F-氟脱氧葡萄糖正电子发射断层扫描摄取的相关性。
Correlations between circulating tumor cell phenotyping and 18F-fluorodeoxyglucose positron emission tomography uptake in non-small cell lung cancer.
机构信息
Department of Respiratory Medicine, Northern Jiangsu Province Hospital, Clinical Medical College of Yangzhou University, 28 Nan Tong Road, Yangzhou, 225001, People's Republic of China.
Department of Neurosurgery, Northern Jiangsu Province Hospital, Clinical Medical College of Yangzhou University, Yangzhou, 225001, People's Republic of China.
出版信息
J Cancer Res Clin Oncol. 2020 Oct;146(10):2621-2630. doi: 10.1007/s00432-020-03244-4. Epub 2020 Jul 13.
PURPOSE
The epithelial-to-mesenchymal transition (EMT) phenotype-based subsets of circulating tumor cells (CTCs) might be predictors of tumor progression. We evaluated the clinical properties of different phenotypic CTCs in patients with non-small cell lung cancer (NSCLC). Secondly, we explored the association between different phenotypic CTCs and the uptake of 18F-fluorodeoxyglucose (FDG) by the primary tumor on a positron emission tomographic (PET) scan.
METHODS
Venous blood samples from 34 pathologically confirmed Stage IIB-IVB NSCLC patients were collected prospectively. CTCs were immunoassayed using a SE-i·FISH®CTC kit. We identified CTCs into cytokeratin positive (CK) and cytokeratin negative (CK) phenotypes. CTC classifications were correlated with the maximum standardized uptake value (SUVmax) measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Overall survival (OS) and progression-free survival (PFS) curves were produced using the Kaplan-Meier method.
RESULTS
CTCs were detected in 91.2% of NSCLC patients. CTC counting was associated with TNM stage (P = 0.014) and distant metastasis (P = 0.007). The number of CKCTCs was also positively associated with TNM stage (P = 0.022) and distant metastasis (P = 0.007). Both total CTC counting and CKCTC counting did not show association with SUVmax value (P = 0.959, P = 0.903). Kaplan-Meier survival analysis demonstrated that patients with ≥ 7 CTCs had shorter OS (P = 0.003) and PFS (P = 0.001) relative to patients with < 7 CTCs). Notably, the number of CKCTCs can act as independent risk factors for PFS (P = 0.044) and OS (P = 0.043) in NSCLC patients. However, SUVmax value was not associated with OS (P = 0.895) and PFS (P = 0.686).
CONCLUSION
The CTC subpopulations could be useful evidence for testing metastasis and prognosis in NSCLC patients. The SUVmax value of the primary tumor was not related to prognosis in patients with NSCLC.
目的
基于上皮-间质转化（EMT）表型的循环肿瘤细胞（CTC）亚群可能是肿瘤进展的预测因子。我们评估了非小细胞肺癌（NSCLC）患者不同表型 CTC 的临床特征。其次，我们探讨了不同表型 CTC 与正电子发射断层扫描（PET）原发性肿瘤摄取 18F-氟脱氧葡萄糖（FDG）之间的关系。
方法
前瞻性收集 34 例经病理证实的 IIB-IVB 期 NSCLC 患者的静脉血样本。使用 SE-i·FISH®CTC 试剂盒对 CTC 进行免疫检测。我们将 CTC 鉴定为细胞角蛋白阳性（CK）和细胞角蛋白阴性（CK）表型。CTC 分类与 18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）测量的最大标准化摄取值（SUVmax）相关。使用 Kaplan-Meier 方法生成总生存期（OS）和无进展生存期（PFS）曲线。
结果
91.2%的 NSCLC 患者检测到 CTC。CTC 计数与 TNM 分期（P=0.014）和远处转移（P=0.007）相关。CKCTC 数量也与 TNM 分期（P=0.022）和远处转移（P=0.007）呈正相关。总 CTC 计数和 CKCTC 计数均与 SUVmax 值无相关性（P=0.959，P=0.903）。Kaplan-Meier 生存分析表明，与 CTC 计数＜7 相比，CTC 计数≥7 的患者 OS（P=0.003）和 PFS（P=0.001）更短。值得注意的是，CKCTC 数量可作为 NSCLC 患者 PFS（P=0.044）和 OS（P=0.043）的独立危险因素。然而，SUVmax 值与 OS（P=0.895）和 PFS（P=0.686）无关。
结论
CTC 亚群可作为 NSCLC 患者转移和预后检测的有用证据。原发性肿瘤的 SUVmax 值与 NSCLC 患者的预后无关。
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