| OBJECTIVE:To analyze the correlation between CTC count and clinical parameters,therapeutic effect and prognosis in patients with advanced non-small cell lung cancer(NSCLC).METHODS:A retrospective analysis was conducted on 54 patients with advanced non-small cell lung cancer diagnosed in Zhongshan Affiliated Hospital of Dalian University Hospital from July 2013 to August 2017.All patients received 7.5ml of morning fasting peripheral blood one day before the start of systemic treatment(baseline)and after the first follow-up;CellSearch system was used for CTC detection.CTC ?1 was determined as positive.General clinical data was recorded and the relationship between baseline CTC count and clinical parameters was analyzed;The dynamic changes of CTC before and after treatment were compared,and the relationship between the dynamic changes of CTC and the therapeutic effect of patients was analyzed;Kaplan-meier method was used to draw the survival curve and analyze the relationship between CTC dynamic changes and patient survival;Cox proportional risk regression model was used to analyze the relationship between statistical variables and prognosis of NSCLC.P < 0.05 was considered statistically significant.RESULTS: Baseline CTC count of 54 patients with advanced NSCLC was not associated with gender,age,smoking history,pathological type,clinical stage and treatment method.Baseline CTC negative patients had longer PFS[(6.0±2.8)months vs(3.0±1.5)months,P=0.012] and OS[(23.0±3.0)months vs(9.0±1.4)months,P=0.021]than CTC positive patients.Patients with reduced or unchanged CTC count had longer PFS[(6.0±0.6)months vs(4.0±1.5)months,P=0.428] and OS[(17.0±5.1)months vs(12.0±7.5)months,P=0.960] than patients with increased CTC count after anti-cancer therapy.Patients whose CTC count decreased or remained unchanged after treatment had longer PFS[(3.0±1.3)months vs(2.0±2.8)months,P=0.954] and OS[(9.0±2.0)months vs(3.0±3.3)months,P=0.119] than those whose CTC count increased.Patients with negative baseline CTC whose CTC count decreased or remained unchanged after treatment had longer PFS[(9.0±2.3)months vs(4.0±1.2)months,P=0.231] and OS[(21.0±3.8)months vs(13.0±3.9)months,P=0.195].Among the patients whose CTC count increased after treatment compared with pre-treatment.64.7%(11/17)of patients were assessed as PD,and among the patients whose CTC count decreased or remained unchanged after treatment,75.7%(28/37)were assessed as PR/SD.The above differences were statistically significant(P=0.004).According to the different treatment methods,54 patients were divided into 4 groups.In each group,most patients with PD were evaluated as having increased CTC count after treatment,while most patients with PR/SD were evaluated as having less or unchanged CTC count after treatment,and the above differences were not statistically significant(P > 0.05).COX regression analysis showed that CTC was an independent factor affecting the prognosis of patients with advanced NSCLC(HR=0.423,95%CI:0.203-0.882,P=0.022).CONCLUSIONS: In patients with advanced NSCLC,there was no significant correlation between peripheral blood baseline CTC count and clinical parameters such as gender,age,smoking history,pathological type,clinical stage and treatment mode.The CTC negative group had longer median PFS and OS than the CTC positive group.During treatment,the dynamic change of CTC in peripheral blood was related to PFS and OS,and patients whose CTC count decreased or remained unchanged during treatment had longer PFS and OS than those whose CTC count increased.The dynamic change of CTC in peripheral blood could reflect the therapeutic efficiency of patients with advanced NSCLC.Meanwhile,CTC was an independent factor affecting the prognosis of NSCLC patients. |
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