Clinical Significance Of Cyttel~? Circulating Tumor Cells Detection In Patients With Non-small Cell Lung Cancer

ObjectiveTo investigate the correlation not only between CTCs and clinicolpathological features,but also between CTCs and metabolic-related varibles.We also analyse the clinical significance of circulating tumor cells in patients with non-small cell lung cancer.And to compare with Cyttel~? and SE-iFISH for circulating tumour-cell detection in patients with non-small cells lung cancer.MethodA total of 82 patients with non-small cell lung cancer were incruited in the oncology department of the First Affiliated Hosipital of Jinan Universitiy from July,2017 to January,2019.The count of CTCs were detected before chemotherapy and after 2cycle chemotherapy.Collect clinical data of all enrolled patients.The correlations between CTCs and clinicolpathological features were analysed by chi-square test,and Kaplan-Meier survival curve was used to analysed prognostic of CTCs in patients with non-small cell lung cancer.We also collect 20 blood samples dectected byCyttel~? and SE-iFISH.Result1.Among the 82 patients,CTCs were detected in 55 patients and the positive rate was67%,and 27 patients were detected negative result.The positive rate of patients with stage I-III were arange from 50%to 54%,however the positive rate of patients with stage IV was 76%,and there was a significant difference between CTCs and stage(P=0.032).2.An unfavorable CTCs number was significantly associated with stage,and number of sites of metastasis(P=0.032,P=0.048).However,there was no significant difference between CTCs and patient’s age(P=0.310),gender(P=0.803),histology(P=0.830),KPS(P=0.240),distant lymphnode(P=0.410),pleural effusion(P=0.668)as well.3.We found that the precence of CTCs was significantly associated with the Lipoprotein a level(P=0.044),but the presence of CTCs was not related to the level of BMI(P=0.834),Hemoglobin(P=0.462),Serum Albumin(P=0.484),Apolipoprotein A(P=1.000),High-density Lipoprotein(P=0.462),as well as Blood Glucose level(P=0.860).4.Of the 82 patients enrolled,51patients underwent tumor assessments after the second cycle of chemotherapy.A partial response(PR)was observed in 9 patients,stable disease(SD)was observed in 19 and progressive disease(PD)was observed in23.We found that patients with post-treatment decrease in the CTCs count tended to have higher PR rates and lower PD rates,and there was a significant difference in the chemotherapeutic response between the favorable and unfavorable groups(P=0.022).5.There were 18 patients with post-treatment increases in the CTCs count,and 25patients with post-treatment decrease in the CTCs count,and 8 patients with post-treatment unchange in the CTCs count.Change in the CTCs count after chemotherapy was correlated with survival(P=0.002).Patients with post-treatment increases(midian PFS:3 months)in the CTCs count had poorer clinical outcomes versus those without post-treatment increases(midian PFS:9 months).6.The midian PFS of negative patients is 4.0 months,while the positive patients is 6.0months,there was no significant difference in the baseline CTCs number between the positive and negative groups.7.A direct comparison of Cyttel~? and SE-iFISH for circulating tumour-cell detection in patients with non-small cells lung cancer.CTCs were detected in 14 patients and the positive rate was 73.7%by Cyttel~? Detection,however CTCs positive rate was84.2%by SE-iFISH.CECs were detected in 16 patients by SE-iFISH,but it can not be detected by by Cyttel~? Detection.Conclusion1.CTCs number was significantly associated with stage,number of sites of metastasis and the level of lipoprotein a.2.The change of CTCs number after two cycle of chemotherapy show consistent with imaging assessment results for chemotherapeutic effect.,becoming a predictor fator of chemotherapeutic response.3.The change of CTCs number after chemotherapy is a predictor fator of PFS for non-small cell lung cancer.4.The SE-iFISH method improves the specificity and sensitivity of CTCs detection based on the Cyttel?method,and provides a new direction for detecting CTCs in non-small cell lung cancer.