Song Jinghan, Ye Xiong, Peng Qianqian, Ying Xinnan, Xiao Hui
Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, China.
BMC Cancer. 2024 Dec 3;24(1):1491. doi: 10.1186/s12885-024-13245-y.
Surgical resection is an important treatment option for patients with non-small cell lung cancer (NSCLC). However, recurrence and survival rates remain a cause of concern. To further improve prognosis, more studies have focused on liquid biopsy, which has significant value as a prognostic factor for defining the risk stratification of postoperative NSCLC patients. This study aimed to identify circulating tumor cells (CTCs) as biomarkers that indicate a poor prognosis, combined with multiple indicators to determine prognostic risks in advance and develop individualized treatment strategies.
Between November 2015 and August 2018, 65 radical resected patients with NSCLC were analyzed. Preoperative CTCs were collected, and follow-up lasted until August 2023. Overall survival (OS) and disease-free survival (DFS) were the primary outcomes.
With an 11 CTC unit threshold, the high preoperative CTC level group had worse OS and DFS than the low-level group, suggesting that preoperative CTC levels have prognostic value. Time-dependent receiver operating characteristic (ROC) curves also showed satisfactory predictive efficiency of CTCs. Univariate analysis revealed that preoperative CTC levels were significantly associated with increasing risks for OS and DFS. Moreover, we combined CTCs and multiple indicators to provide a reference for a group at high risk of adverse outcomes.
CTCs serve as feasible biomarkers for predicting postoperative prognosis in NSCLC patients. The combination of hematological, radiological, and pathological features could be valuable tools to guide postoperative management and treatment decisions in these patients. A multimodal prognostic approach is important for the clinical evaluation of lung cancer.
手术切除是非小细胞肺癌（NSCLC）患者的重要治疗选择。然而，复发率和生存率仍然令人担忧。为了进一步改善预后，更多研究聚焦于液体活检，其作为定义NSCLC术后患者风险分层的预后因素具有重要价值。本研究旨在将循环肿瘤细胞（CTC）鉴定为指示预后不良的生物标志物，结合多个指标提前确定预后风险并制定个体化治疗策略。
2015年11月至2018年8月期间，对65例接受根治性切除的NSCLC患者进行分析。收集术前CTC，随访持续至2023年8月。总生存期（OS）和无病生存期（DFS）为主要观察指标。
以11个CTC单位为阈值，术前CTC水平高的组比低水平组的OS和DFS更差，表明术前CTC水平具有预后价值。时间依赖性受试者工作特征（ROC）曲线也显示CTC具有令人满意的预测效率。单因素分析显示，术前CTC水平与OS和DFS风险增加显著相关。此外，我们将CTC与多个指标相结合，为不良结局高风险组提供参考。
CTC可作为预测NSCLC患者术后预后的可行生物标志物。血液学、放射学和病理学特征的结合可能是指导这些患者术后管理和治疗决策的有价值工具。多模式预后方法对肺癌的临床评估很重要。
