The Correlation Between CTCs Detection And RECIST Standard Evaluation In NSCLC Chemotherapy Efficacy Evaluation

Objective:In this study,we monitored the amount of circulating tumor cells(CTCs)in NSCLC patients before and after chemotherapy,to compare with the Response Evaluation Criteria in Solid Tumor,further to explore the value of its clinical application.Methods: From December 2016-October 2017,54 patients of newly diagnosed non-small cell lung cancer in PKU Care Lu Zhong Hospital were enrolled in this analysis,four patients were excluded for unfitting the enrolling criteria.All patients were confirmed by histopathology.All the cases were tested for CTCs before chemotherapy.After 2 cycles of chemotherapy,all patients were evaluated by CT examination and CTCs testing with peripheral blood.The results of CTCs evaluation were compared with Recist evaluated results and the CTCs data were analysed to difference clinical charicateristics.The data were analysed by SPSS18.0 software.Results:1.We tested the CTCs of 50 cases before chemotherapy,and 42 cases were positive for the first time,It was 84%,with a mean value of 16;46 cases were positve for the second time,it was 92%,the mean number was 15;40 cases were positve for the third time,it was 80%,the mean number was 11;19 cases were positive for the forth time,it was 38%,the mean number was 7.2.According to the results of chi-square test,the CTCs positive rates were associated with the pathological differentiation,the well differenciated presented with low CTCs,and the difference was statistically significant(P=0.004).The positive rate of CTCs was independent of gender,smoking history and age,and the difference was not statistically significant(P>0.05).3.The CTCs positivity was 92% after the 2-cycle chemotherapy,which was higher than 84% before chemotherapy,but the difference was not statistically significant(P>0.05);The CTCs positivity was 80% after 4-cycle chemotherapy,which was slightly lower than 84% before chemotherapy,but the difference was not statistically significant(P>0.05);After 6 cycles of chemotherapy,the positivivity of CTCs was 38%,which was significantly lower than 84% before chemotherapy.The difference was statistically significant(p=0.004).4.According to RECIST criteria,after 6 cycles of chemotherapy,22 patients showed PR,37 patients with SD,18 patients with PD,1 patient with CR.CTCs increased in 12 patients after chemotherapy compared with pre-chemotherapy,declined in 20 cases,stable in 18 cases.There was a consistency between CTCs level and image evaluation.5.9 patients of the evaluated CTCs positive patients showed progression of the diseases,accounting for 18%.No patients showed progression in the 8 negative CTCs patients.The median survival was 8.3 months for patients with positive CTCs,and 12.9 months for patients with negative CTCs,the difference was statistically difference.Conclusion: 1.The changes of CTCs before and after chemotherapy were consistent with the evaluation of therapeutic response of RECIST criteria.2.CTCs level before chemotherapy was a predictor of PFS.