Abstract
BackgroundLung cancer is the leading cause of death caused by malignant tumors. PD-L1(programmed cell death protein-1) has shown tremendous achievement in treating NSCLC. We sought to find the relationship between CTCs in the pulmonary vein and postoperative PFS, besides we detected PD-L1 in CTCs.MethodWe enrolled 112 NSCLC patients. CTC tests were performed at four time points (preoperative, pulmonary vein, intraoperative and postoperative) on every NSCLC patient who received surgery. The RNA of PD-L1 was tested by FISH. The levels of the PD-L1 mRNA and protein in tissue samples were detected.ResultsThe CTCs in the PV were the highest (P< 0.001), and CTCs in the PPA were the lowest (P< 0.001). The PFS in the group with PV CTCs≥ 16/5 ml was shorter than that in the group with PV CTCs< 16/5 ml (11.1 months vs 21.2 months, respectively; P< 0.001). The PFS in the group with PPA CTCs≥ 3/5 ml was shorter than that in the group with CTCs< 3/5 ml (14.8 months vs 20.7 months, respectively; P< 0.001). The CTCs in stage I were lower than those in stage II-IV (P = 0.025). No linear relationship was found between the CTCs and tumor size (P> 0.05) or LN metastasis (P> 0.05). In total, fifty-two (50.5%) patients had positive PD-L1 expression in CTC. In PD-L1-positive CTC patients, the value of PD-L1 tissue expression was higher than that in PD-L1-negative CTC patients (P = 0.0153).ConclusionCTCs in the pulmonary vein can be an effective prognosis indicator of NSCLC patients.
Highlights
Lung cancer, known as a public health problem in the world, is the leading cause of death caused by malignant tumors worldwide
No linear relationship was found between the circulating tumor cells (CTC) and tumor size (P> 0.05) or LN metastasis (P> 0.05)
CTC in PV and peripheral arterial provide a metric for programmed cell death ligand 1 (PD-L1) diagnosis and prognosis of patients with non-small cell lung cancer (NSCLC)
Summary
Known as a public health problem in the world, is the leading cause of death caused by malignant tumors worldwide. According to Cancer Statistics published in CA, the estimated new cases and deaths caused by lung cancer in 2018 are 234,030 and 154,050, respectively [1]. Despite advances in cancer therapy, the overall five-year survival rate for high grade lung cancer remains less than 20 percent [3]. In 2011, data from the National Lung Screening Trial (NLST) showed that early screening can promote the development of early detection, early diagnosis and early intervention; CT screening could decrease the total death rate by 19% (RR = 0.81; 95% CI: 0.70~0.92). Some patients diagnosed with advanced lung cancer can be treated by chemotherapy, targeted therapy and immunotherapy. Lung cancer is the leading cause of death caused by malignant tumors. We sought to find the relationship between CTCs in the pulmonary vein and postoperative PFS, besides we detected PD-L1 in CTCs
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