Department of Thoracic Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
SurExam Bio-Tech, Guangzhou Technology Innovation Base, 80 Lan Yue Road, Science City, Guangzhou, China.
BMC Pulm Med. 2020 Oct 20;20(1):274. doi: 10.1186/s12890-020-01314-4.
The early diagnosis of non-small cell lung cancer is of great significance to the prognosis of patients. However, traditional histopathology and imaging screening have certain limitations. Therefore, new diagnostical methods are urgently needed for the current clinical diagnosis. In this study we evaluated the sensitivity and specificity of CanPatrol™ technology for the detection of circulating tumor cells in patients with non-small cell lung cancer (NSCLC).
CTCs in the peripheral blood of 98 patients with NSCLC and 38 patients with benign pulmonary diseases were collected by the latest typing of CanPatrol™ detection technology. A 3-year follow-up was performed to observe their recurrence and metastasis. Kruskal-Wallis test was used to compare multiple groups of data, Mann-Whitney U test was used to compare data between the two groups, and ROC curve analysis was used to obtain the critical value. The COX risk regression and Kaplan-Meier survival analysis were performed in the 63 NSCLC patients who were effectively followed up.
The epithelial, epithelial-mesenchymal, and total CTCs were significantly higher in NSCLC patients than that in patients with benign lung disease (P < 0.001). The mesenchymal CTCs of NSCLC patients was slightly higher than that of benign lung diseases (P = 0.013). The AUC of the ROC curve of the total CTCs was 0.837 (95% CI: 0.76-0.914), and the cut-off value corresponding to the most approximate index was 0.5 CTCs/5 ml, at which point the sensitivity was 81.6% and the specificity was 86.8%. COX regression analysis revealed that the clinical stage was correlated with patient survival (P = 0.006), while gender, age, and smoking were not (P > 0.05). After excluding the confounders of staging, surgery, and chemotherapy, Kaplan-Meier survival analysis showed that patients in stage IIIA with CTCs ≥0.5 had significantly lower DFS than those with CTCs < 0.5 (P = 0.022).
CTC positive can well predict the recurrence of NSCLC patients. CanPatrol™ technology has good sensitivity and specificity in detecting CTCs in peripheral blood of NSCLC patients and has a certain value for clinical prognosis evaluation.
非小细胞肺癌的早期诊断对患者的预后具有重要意义。然而,传统的组织病理学和影像学筛查存在一定的局限性。因此,目前临床诊断迫切需要新的诊断方法。本研究评估了 CanPatrol™ 技术检测非小细胞肺癌(NSCLC)患者循环肿瘤细胞的敏感性和特异性。
采用最新分型的 CanPatrol™ 检测技术收集 98 例 NSCLC 患者和 38 例良性肺部疾病患者外周血中的 CTCs,对患者进行 3 年随访,观察其复发转移情况。采用 Kruskal-Wallis 检验比较多组数据,采用 Mann-Whitney U 检验比较两组间数据,采用 ROC 曲线分析获得临界值。对 63 例有效随访的 NSCLC 患者进行 COX 风险回归和 Kaplan-Meier 生存分析。
NSCLC 患者上皮、上皮-间质和总 CTCs 明显高于良性肺部疾病患者(P<0.001)。NSCLC 患者的间质 CTCs 略高于良性肺部疾病患者(P=0.013)。总 CTCs 的 ROC 曲线 AUC 为 0.837(95%CI:0.76-0.914),对应最接近指标的截断值为 0.5 CTCs/5 ml,此时灵敏度为 81.6%,特异性为 86.8%。COX 回归分析显示,临床分期与患者生存相关(P=0.006),而性别、年龄和吸烟与生存无关(P>0.05)。排除分期、手术和化疗的混杂因素后,Kaplan-Meier 生存分析显示 IIIA 期 CTCs≥0.5 的患者无病生存期明显低于 CTCs<0.5 的患者(P=0.022)。
CTC 阳性可很好地预测 NSCLC 患者的复发。CanPatrol™ 技术在外周血中检测 NSCLC 患者 CTCs 具有良好的灵敏度和特异性,对临床预后评估具有一定价值。