Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Division of Oncology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Stem Cells Transl Med. 2022 Mar 31;11(3):239-247. doi: 10.1093/stcltm/szab029.
Lung cancer relapse may be associated with the presence of a small population of cancer stem cells (CSCs) with unlimited proliferative potential. Our study assessed the relationship between CSCs and the relapse rate in patients harboring adenocarcinoma (ADL) and squamous cell carcinoma of the lung (SCCL).
This is an observational prospective cohort study (NCT04634630) assessing the influence of CSC frequency on relapse rate after major lung resection in 35 patients harboring early (I-II) (n = 21) and locally advanced (IIIA) (n = 14) ADL and SCCL. There was a 2-year enrollment period followed by a 1-year follow-up period. Surgical tumor specimens were processed, and CSCs were quantified by cytofluorimetric analysis.
Cancer stem cells were expressed in all patients with a median of 3.1% of the primary cell culture. Primary analysis showed no influence of CSC frequency on the risk of relapse (hazard ratio [HR] = 1.05, 95% confidence interval [CI] = 0.85-1.30). At secondary analysis, patients with locally advanced disease with higher CSC frequency had an increased risk of relapse (HR = 1.26, 95% CI = 1.14-1.39), whereas this was not observed in early-stage patients (HR = 0.90, 95% CI = 0.65-1.25).
No association was found between CSC and relapse rates after major lung resection in patients harboring ACL and SCCL. However, in locally advanced-stage patients, a positive correlation was observed between CSC frequency and risk of relapse. These results indicate a need for further molecular investigations into the prognostic role of CSCs at different lung cancer stages.
NCT04634630.
肺癌复发可能与具有无限增殖潜力的少量癌症干细胞（CSC）有关。我们的研究评估了 CSC 与携带腺癌（ADL）和肺鳞状细胞癌（SCCL）的患者复发率之间的关系。
这是一项观察性前瞻性队列研究（NCT04634630），评估了 35 例早期（I-II）（n=21）和局部晚期（IIIA）（n=14）ADL 和 SCCL 患者接受大肺切除术后 CSC 频率对复发率的影响。有一个 2 年的入组期，随后是 1 年的随访期。手术肿瘤标本进行处理，通过流式细胞仪分析定量 CSC。
所有患者均表达 CSC，原代细胞培养的中位数为 3.1%。初步分析显示 CSC 频率对复发风险无影响（危险比[HR]=1.05，95%置信区间[CI] = 0.85-1.30）。在二次分析中，具有较高 CSC 频率的局部晚期疾病患者复发风险增加（HR=1.26，95%CI=1.14-1.39），而早期患者则没有观察到这种情况（HR=0.90，95%CI=0.65-1.25）。
在携带 ACL 和 SCCL 的患者中，大肺切除术后 CSC 与复发率之间未发现相关性。然而，在局部晚期患者中，CSC 频率与复发风险之间存在正相关。这些结果表明，需要进一步进行分子研究，以了解 CSC 在不同肺癌阶段的预后作用。
NCT04634630。
