Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Infectious Diseases, People's Hospital of Zhong Shan County, Hezhou, China.
Eur Arch Otorhinolaryngol. 2024 Sep;281(9):4963-4972. doi: 10.1007/s00405-024-08714-w. Epub 2024 May 11.
Advancements in nasopharyngeal carcinoma (NPC) treatment have led to a focus on personalized treatment. Circulating tumor cells (CTCs) are important for liquid biopsies and personalized treatment but are not being fully utilized. This study examined how pre- and post-treatment CTC counts, EMT subtypes, clinical characteristics, and patient prognosis are related in order to support the use of liquid biopsy in managing NPC.
This retrospective study included 141 patients with locally advanced NPC. All patients underwent CanPatrol™ CTC detection pre- and post-treatment and were categorized into EMT subtypes: epithelial type, mixed type, and mesenchymal type. This study analyzed CTC enumeration, EMT subtypes, and their associations with clinical characteristics and survival outcomes.
The results indicated a positive correlation between the pre-treatment detection rate of CTCs and N stage (P < 0.01), alongside a positive correlation with the TNM clinical stage (P = 0.02). Additionally, the detection rate of mesenchymal CTCs post-treatment is positively associated with the N stage (P = 0.02). The enumeration of CTCs pre- and post-treatment is negatively correlated with prognosis and has statistical significance. Additionally, an investigation into the EMT subtypes of CTCs revealed a significant association between the presence of mesenchymal CTCs pre- and post-treatment and decreased overall survival (OS) (P < 0.05). Furthermore, T stage, N stage, TNM clinical stage, and Epstein-Barr virus (EBV) DNA were also significantly correlated with OS.
The study found that mesenchymal CTCs pre- and post-treatment, as well as the number of CTCs, were linked to a poor prognosis.
鼻咽癌（NPC）治疗的进步促使人们关注个性化治疗。循环肿瘤细胞（CTC）对于液体活检和个性化治疗很重要，但尚未得到充分利用。本研究旨在探讨治疗前后 CTC 计数、上皮间质转化（EMT）亚型、临床特征和患者预后之间的关系，以支持液体活检在 NPC 管理中的应用。
本回顾性研究纳入了 141 例局部晚期 NPC 患者。所有患者均在治疗前后接受 CanPatrol™ CTC 检测，并分为 EMT 亚型：上皮型、混合型和间质型。本研究分析了 CTC 计数、EMT 亚型及其与临床特征和生存结局的相关性。
结果表明，治疗前 CTC 检测率与 N 分期呈正相关（P<0.01），与 TNM 临床分期呈正相关（P=0.02）。此外，治疗后间质型 CTC 检测率与 N 分期呈正相关（P=0.02）。治疗前后 CTC 计数与预后呈负相关，具有统计学意义。此外，对 CTC 的 EMT 亚型进行研究发现，治疗前后间质型 CTC 的存在与总生存期（OS）降低显著相关（P<0.05）。此外，T 分期、N 分期、TNM 临床分期和 Epstein-Barr 病毒（EBV）DNA 也与 OS 显著相关。
本研究发现，治疗前后间质型 CTC 及其数量与预后不良有关。
