The value of chromosome 8 heteroploid tumor cells in the peripheral blood and pleural effusion in evaluating treatment efficacy and the prognosis of metastatic non-small cell lung cancer patients.

BACKGROUND

Non-small cell lung cancer (NSCLC) is a major global health concern, especially in its advanced stages, where patient prognosis is frequently unfavorable. Research has shown that circulating tumor cells (CTCs) can serve as markers of tumor dissemination, and CTCs may influence chemotherapy effectiveness and survival rates in patients with malignant pleural effusion. Moreover, chromosomal abnormalities, particularly chromosome 8 aneuploidy, have significant potential implications for disease progression and the treatment response. The aim of this study is to elucidate the relationships between CTCs, chromosome 8 aneuploidy and the chemotherapy response and survival outcomes of metastatic NSCLC patients.

METHODS

We examined 26 newly diagnosed NSCLC patients with malignant pleural effusion. Specifically, we employed a combination of separation enrichment (SE) and interphase fluorescence hybridization (iFISH) techniques to isolate and characterize CTCs from peripheral blood and pleural effusion samples. We assessed the detection rates and chromosomal features of CTCs in relation to the treatment response and clinical outcomes.

RESULTS

We found that CTCs were present in 92.3% of the patients, and we observed a significant decrease in the aneuploid CTC counts of the patients who exhibited partial responses (PRs) to chemotherapy (P=0.002). Notably, the detection of ≥2 trisomy or tetrasomy CTCs post-treatment was associated with shorter progression-free survival (PFS) (P=0.03). Additionally, the presence of aneuploid tumor cells in pleural effusion was correlated with poorer PFS and overall survival (OS) outcomes (P=0.001 and P=0.002, respectively).

CONCLUSIONS

The results suggest that CTC counts and their chromosomal features could serve as significant prognostic indicators for predicting treatment responses in NSCLC. Future studies with larger patient cohorts need to be conducted to validate these findings and assess the feasibility of using CTC analyses as routine clinical instruments. This approach could ultimately contribute to the development of personalized treatment plans for the effective management of NSCLC.