Circulating tumor cells in peripheral and pulmonary venous blood predict poor long-term survival in surgically resected non-small cell lung cancer patients — ASN Events
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Circulating tumor cells in peripheral and pulmonary venous blood predict poor long-term survival in surgically resected non-small cell lung cancer patients (#305)

Zhidong Liu 1 , Ruidong Zhang 2 , Yunsong Li 1 , Zhong Chen 3 , Chongyu Su 1 , Yi Han 1
  1. Beijing Chest Hospital, Capital Medical University, Beijing, China
  2. Beijing Children's Hospital, Beijing, China
  3. Tumor Biology Section, Head and Neck Surgery Branch, NIDCD, National Institutes of Health, Bethesda, MD, USA

Background: We tested the hypothesis that the circulating tumor cells (CTCs) in preoperative peripheral blood (PPB) and intraoperative pulmonary venous blood (IPVB) could predict poor long term survival in surgically resected NSCLC patients.

Method: CTCs were separated from the blood using magnetic beads coated by antibody against epithelial-cell adhesion molecule (EpCAM) through magnetic activated cell sorting (MACS). The CTCs were quantified with fluorescence labeled antibodies against pan-cytokeratin through flow cytometry. CTCs were prospectively quantified in PPB and IPVB in 23 consecutive stage I-IIIA patients with surgically resected NSCLC. Association between CTCs and prognosis of these patients was evaluated after 5-year follow-up.

Results: In the NSCLC patients, outcomes were assessed according to levels of CTCs at surgery, and compared with CTCs detected in benign pulmonary diseases, and healthy volunteers, where the mean and 95%CI of CTCs counts were all <1.0 CTCs/15 mL. In cancer patients, the median of PPB-CTCs was 5/15mL, and the median of IPVB-CTCs was 28/15mL. NSCLC patients were identified as high-risk groups, as>5 CTCs/15mL in PPB and >50 CTCs/15mL in IPVB. Univariate Cox proportional-hazards regression analysis showed that CTCs count in PPB or IPVB was an independent risk factor for tumor-free and overall survivals. The high risk group of patients had a shorter median tumor-free survival (22 months vs. >60.0 months, P<0.0012) and shorter overall survival (27 months vs. >60 months, P<0.0015).

Conclusions: CTCs count in PPB and IPVB was an independent risk factor for tumor-free and overall survival in surgically resected NSCLC patients.

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