Detection Of Circulating Tumor Cells And Serum Free Dna In Skin Factor Growth Receptor Gene Mutations In Lung Cancer Diagnosis And Treatment Of Clinical Significance

BackgroundWe explored the clinical value of circulating tumor cells(CTCs) in prognosis and the assessment of treatment effects for patients with lung cancer.MethodsIn a prospective,single center and small sampling study,we tested the levels of CTC at baseline in 144 patients with emerging or recurring lung cancer and followed up 52 with CTC numbers after each cycle of chemotherapy.We then did correlation analysis between CTC variation and treatment-response evaluation based on RECIST criteria.We used AVIVABio Cancer Cell Isolating Technology,an immunomagnetic beads-based rare cell enrichment system using leukocyte depletion mechanism,to count the identified CK18+/CD45-CTCs in 7.5ml venous blood of the lung cancer patients under fluorescence microscopy.Results144 blood samples were collected from newly diagnosed or recurrent lung cancer patients who had been treatment-naive for at least 2 months before hospitalization. Benign respiratory diseases including tuberculosis and healthy control samples were collected,28 and 35 samples,respectively,during the same study period.The AVIVABio Technology is easy to manage and repeatable with a sensitivity of 93.1%and specificity of 72.8%in lung cancer patients.The patients with TNM stageⅢA had a CTC positive rate of 32.0%(8/25),and those ofⅢB 56.8%(21/37) andⅣ78.0%(64/82) (P＜0.01).52 patients were followed up with CTC after each cycle of chemotherapy for less than 6 cycles.After one chemo cycle,CTC positive rate fell from 69.2%(36/52) to 28.8%(15/52).Correlation analysis showed the variation of post-cycle 1 CTC was coincident with RECIST criteria by CT scan after two chemo cycles.ConclusionThe above-mentioned method is highly sensitive and specific in detecting CTC of the patients with advanced lung cancer.CTC is closely related to the metastasis status of the tumor.The initial level of CTC and right after the therapy identified using this method has strong prognostic value.The variation of CTC in the course of chemotherapy might be a useful indicator of the chemo-response or disease-progression.