Circulating Tumor Cells as a Biomarker for Precise Management of Lung Cancer [post]

Qian Li, Chenyu Xu, Zhenhua Yang
2021 unpublished
Background: Circulating tumor cells (CTCs) with potential utility in cancer treatment provide a less invasive way to illustrate the pathogenesis of tumor. In this study, we evaluated the efficiency of CTCs in early diagnosis and/or precisely indication of lung cancer (LC) patients responding to chemotherapy.Methods: Fifty-six patients newly diagnosed with LC were included in this study, while 42 patients with nonmalignant pulmonary disease were included as positive control group and 27 healthy
more » ... ndividuals as control. CTCs were measured at baseline in all eligible subjects and after two cycles of chemotherapy in 25 advanced LC patients, with a strategy of negative enrichment combined with immunostaining-fluorescence in situ hybridization (imFISH). The receiver operating characteristic (ROC) curve was plotted to determine the sensitivity and specificity of the CTC for the LC diagnosis. Kaplan-Meier curve and two-sided log-rank test were used for univariate survival analysis.Results: The number of CTCs was significantly increased in LC patients, compared with positive control and healthy controls. The sensitivity and specificity were 87.5% and 95.7%, with a cutoff value of 2 cells/3.2ml (AUC=0.975, 95%CI, 0.953-0.998, p=0.001). Moreover, the sensitivity of CTCs was much higher than individual or the combination of serum tumor markers (NSE/CYFRA21-1/CEA), especially in the early diagnosis of LC. Twenty-five advanced LC patients were subsequently followed up for an average of 18.2 months (6-36 months). Decline of CTC count after two cycles of chemotherapy was highly predictive for progression free survival (PFS) (13.5 vs. 8.5 months; p=0.025) and overall survival (OS) (27.6 vs. 16.8 months; p=0.009). Among the patients classified as stable disease (SD) based on post-treatment CT scan after two cycles of chemotherapy, there was significant elevation in the PFS (14.0 vs. 8.7 months; p=0.033) and OS (25.8 vs. 15.9 months; p=0.018) in those with decreased CTC number compared with those presenting stable or elevated CTCs number.Conclusions: CTCs may act as precise biomarker for early detection and therapy monitoring of LC. It may serve as good compensation for imaging.
doi:10.21203/rs.3.rs-598253/v1 fatcat:cketyijy6nes7hehihsczm4aha