Sun Qianqian, Li Weiqing, Yang Donghua, Lin Peter Ping, Zhang Lina, Guo Huiqin
From the Department of Thoracic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China (Sun, Guo).
the Department of Thoracic Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Li).
Arch Pathol Lab Med. 2025 Jan 1;149(1):39-49. doi: 10.5858/arpa.2023-0455-OA.
CONTEXT.—: Most patients with non-small cell lung cancers (NSCLC) are diagnosed at advanced stages. The 5-year survival rate of patients with advanced lung cancer is less than 20%, which makes lung cancer the leading cause of cancer-related deaths worldwide.
OBJECTIVE.—: To identify indicators that can predict the prognosis of lung cancer patients.
DESIGN.—: To determine the correlation between circulating tumor cells (CTCs), circulating tumor-derived endothelial cells (CTECs), and their subtypes and the prognosis of patients with NSCLC, 80 patients with lung cancer were recruited and 48 patients who met the enrollment criteria were selected in this study. Peripheral blood was collected from the enrolled patients before any treatment and analyzed by the subtraction enrichment and immunostaining-fluorescence in situ hybridization technique to determine the correlation between CTCs and CTECs and lung cancer disease progression and to identify prognostic indicators.
RESULTS.—: In all patients, the positive rate of CTCs was 100% and the positive rate of CTECs was 81.3%. Patients with advanced or lymph node metastases had a higher rate of small-size CTC positivity than those with early or no lymph node metastases. Large-size CTEC positivity was higher in patients with advanced NSCLC than in early-stage patients (P = .03). Patients with ≥1 small-size CTC had shorter progression-free survival, and it was an independent prognostic factor.
CONCLUSIONS.—: Small-size CTCs are a reliable prognostic indicator and a probable predictor of the severity of disease in NSCLC patients.
大多数非小细胞肺癌（NSCLC）患者在晚期被诊断出来。晚期肺癌患者的5年生存率低于20%，这使得肺癌成为全球癌症相关死亡的主要原因。
确定能够预测肺癌患者预后的指标。
为了确定循环肿瘤细胞（CTC）、循环肿瘤来源的内皮细胞（CTEC）及其亚型与NSCLC患者预后之间的相关性，本研究招募了80例肺癌患者，并选取了48例符合纳入标准的患者。在任何治疗前从纳入的患者中采集外周血，并通过减法富集和免疫染色-荧光原位杂交技术进行分析，以确定CTC和CTEC与肺癌疾病进展之间的相关性，并识别预后指标。
在所有患者中，CTC的阳性率为100%，CTEC的阳性率为81.3%。晚期或有淋巴结转移的患者小尺寸CTC阳性率高于早期或无淋巴结转移的患者。晚期NSCLC患者大尺寸CTEC阳性率高于早期患者（P = 0.03）。≥1个小尺寸CTC的患者无进展生存期较短，且它是一个独立的预后因素。
小尺寸CTC是NSCLC患者可靠的预后指标和疾病严重程度的可能预测因子。
