The Clinic Study Of Circulating Tumor Cells In Non-small Cell Lung Cancer Patients

Objective:In the present study,the clinic significance of CTCs in NSCLC was reported.Method:We collect 69 cases of blood samples,which included 49 cases of NSCLC,10 cases of benign tumors and 10 healthy volunteer, and enriched the CTC by cell isolating technology.All CTCs were identified by immunofluorescence and the number of CTCs was calculated in different study objects.Correlation of CTCs enumeration and CT evaluation of NSCLC was studied.The change of CTCs number is also observed in different chemotherapy groups(group of anticancer drug with platinum complex vs group of anticancer drug with non-platinum complex) before chemotherapy and after 2 chemotherapy circles.All study objects were followed up for 8 months and 4 patients were missed in observe time.Following the standard of dividing group in breast cancer research to set a medium number of CTC(Reference),we set CTCs≥12/7.5ml blood as medium number and divided the stageⅣpatients into two groups,CTC≥12/7.5ml blood group and CTC＜12.7ml blood group.The radiological response of the stageⅣNSCLC patients after 4 weeks drug or radiotherapy which used to be an agent to predict the overall survival time will also be evaluated when compared with enumeration of CTCs.Results:In 69 study objects,there is no CTCs found in 10 healthy donors and 10 nonmalignant pulmonary tumor patients.The number of CTCs in 5 stageⅠ-ⅡNSCLC patients,14 stageⅢNSCLC and 30 stageⅣNSCLC patients is 0.4±0.55,6.86±16.75 and 18.33±21.32.The CTCs enumeration has no significantly correlate with the burden of tumor which evaluated by CT scanning(r=0.094,p=0.52)。The number change of CTCs in platinum complex chemotherapy group and non-platinum chemotherapy group is more obvious,but the change is no significant(p=0.19).The platinum complex with anticancer drug have more effect on number of CTCs after chemotherapy.ⅣNSCLC patients are divided two groups according the number of CTCs.We find that the NSCLC patients which in the group of CTCs≥12/7.5ml may be more shorter overall survival time in 8 months fellow-up compared the ones in the group of CTCs＜12/7.5ml(5.28±42.28 months vs 6.95±2.17 months,p=0.042).Compared with the radiologic responses,the CTCs was a more better method to predict the overall survival time.Conclusion:The CTCs can be found in NSCLC patients. Enumeration of CTCs is an good and reproducible indication for the evaluation of disease progress and outcome of the chemotherapy. Compared with the traditional radiology method,the CTCs may be a superior surrogate end point to predict the overall survive time inⅣNSCLC patients.