The application of nano-enrichment in CTC detection and the clinical significance of CTCs in non-small cell lung cancer (NSCLC) treatment.

Tengteng Wei,Yong Yang,Guangda Yuan,Rongming Shen,Donglin Zhu,Hongya Xie,Alfons Navarro

doi:10.1371/journal.pone.0219129

Tengteng Wei, Yong Yang + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0219129

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Journal: PloS one	Publication Date: Jul 25, 2019
Citations: 23	License type: CC BY 4.0

Affiliation: Suzhou Municipal Hospital, Nanjing Medical University

Abstract

Circulating tumor cells (CTCs) are an independent prognostic marker in non-small cell lung cancer (NSCLC). CTC numbers are closely related to early diagnosis, clinical stage, therapy surveillance, and prognosis of NSCLC. We used a more efficient nano-enrichment method to detect CTCs in NSCLC patients and explored the clinical value of CTCs. The results showed that CTC numbers in stage IV cases were significantly higher than those in stage I, II or III cases. The number of CTCs in poorly-differentiated cases was significantly higher than that in well-differentiated cases. During six chemotherapy cycles, the average CTC number decreased from 5.8/7.5 ml in cycle #1 to 2.4/7.5 ml in cycle #4 and remained at almost the same level from 4 to 6 cycles. CTC numbers in patients with EGFR mutations was significantly higher than those in patients with no mutations. The average progression free survival (PFS) in the favorable group (CTC ≤ 5/7.5 ml) was 11.3 months, which was longer than that in the unfavorable group (CTC > 5/7.5 ml, 7.2 months). In conclusion, the assessment of NSCLC cannot be performed using a single CTC analysis. The clinical value is more significant in the continuous analysis of CTC data, as well as the cross-validation of other indexes and imaging results.

Highlights

Lung cancer is currently the most common malignancy tumor with the highest morbidity and mortality
Using data collected from 73 non-small cell lung cancer (NSCLC) patients, we explored the clinical value of Circulating tumor cells (CTCs) in recurrence, metastasis, therapy surveillance and prognosis to provide better support for NSCLC therapy
The CTC numbers of NSCLC patients varied with different stages

Summary

Introduction

Lung cancer is currently the most common malignancy tumor with the highest morbidity and mortality. More than one million patients die from lung cancer annually in the world [1]. 80% of lung cancer patients are diagnosed with non-small cell lung cancer (NSCLC), with only 15% surviving for 5 years [2]. Surgery is not possible for most NSCLC patients as primary treatment, because these patients are often diagnosed at an advanced stage. The rates of detection and surgery success have improved with advancements in medical technology, the poor effects of adjuvant therapy and postoperative recurrence still have a substantial negative effect on overall treatment [3, 4].

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