The Clinical Significance Of Circulating Tumor Cells In Peripheral Blood Of Patients With Lung Cancer

Objective:To analyze the relationship of lung cancer between the circulating tumor cells(CTCs)in peripheral blood collected by Cell Search systerm and the clinical parameters,treatment effect,postoperative recurrence and progression-free survival(PFS)of lung cancer patients.Methods:98 cases of patients with lung cancer who were diagnosed and treated at Zhongshan Hospital Affiliated to Dalian University between April 2015 and September 2017 are enrolled in this study.Each patient has a 7.5ml peripheral blood sample taken and is detected and analyzed CTCs by Cell Search system.CTCs?5 is determined as positive.To investigate the relationship between the CTCs and the clinical parameters,treatment effect and the relationship between CTCs,tumor marker and PFS in 39 advanced patients during First-line chemotherapy period.To investigate the relationship between the CTCs and the clinical parameters,treatment effect,PFS in 21 advanced patients during targeted treatment.To investigate the relationship between the CTCs and the recurrence in 38 patients of early lung cancer after operation.Result:(1).Of the 98 patients,21 are CTCs positive and 77 are negative,The positive rate is 21.4%.(2).During the 39 advanced patients of first line chemotherapy,11 are CTCs positive and 28 are negative.There is no correlation between CTCs and age,sex,smoking history,pathological type,clinical staging and blood sampling time.In the CTCs positive patients,6 cases progress compare with 3cases progress in CTCs negative patients.And CTCs is related to the chemotherapy effect.CTCs is associated with patients' PFS.There are 32 cases of non-small cell lung cancer(NSCLC)and 7 cases of small cell lung cancer(SCLC)in the 39 advanced patients with first-line chemotherapy.There is no correlation between CEA(carcino-embryonic antigen)and PFS in NSCLC patients(P=0.1177),and there is no correlation between NSE(neuron-specific enolase)and PFS in SCLC patients(P=0.2808).Univariate analysis show that during the advanced patients of first line chemotherapy,CTCs,gender have impacts on progression free stage of lung cancer.COX multivariate regression analysis showed that CTCs is an independent prognostic factor of PFS during the advanced patients of first line chemotherapy(P=0.012).(3).During the 21 advanced cancer with targeted treatment,5 are CTCs positive and 16 are negative,The positive rate is 23.8%.There is no correlation between CTCs,age,sex,smoking history,clinical staging,gene detection or not,blood sampling time or treatment effect.In the CTCs positive patients,3 cases progress compare with 2 cases progress in CTCs negative patients.the CTCs is not correlated with treatment effect or PFS.(4).38 early postoperative patients during follow-up period,5 are CTCs positive and 33 are CTCs negative,the positive rate is 13.2%.The results show that CTCs is not related to age,sex,smoking history,clinical staging and pathological type.There are 7 cases of local recurrence during the follow-up period,of which only 2 cases are CTCs positive and 5 cases are CTCs negative.31 cases are not recurred,of which 3 cases are CTCs positive and 28 cases of CTCs negative.There is no correlation between CTCs and recurrence after operation(?2=1.784,P=0.223),and no correlation with DFS(P=0.1558).Conclusion:1.CTCs is correlated with chemotherapy effect and PFS during first-line chemotherapy of advanced lung cancer by using the Cellsearch systerm.The positive result may indicate poor prognosis.CTCs is an independent prognostic factor of PFS during first-line chemotherapy.2.The correlation between CTCs checked by Cellsearch systerm and treatment effect of advanced lung cancer during targeted treatment and correlation between CTCs and PFS is still not clear.3.There is no correlation between the early postoperative CTCs checked by Cellsearch systerm and the recurrence of lung cancer.