1. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection
- Author
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José A. Lorente, Miguel Delgado-Rodríguez, Abel Sánchez-Palencia Ramos, Juan Antonio Gómez, María José Serrano, Jose Luis Garcia Puche, Carlos Fernando Giraldo-Ospina, Antonio Guevara, Francisco G. Ortega, Clara Isabel Bayarri-Lara, Diego de Miguel-Pérez, Javier Ruiz Zafra, [Bayarri-Lara,C, Cueto Ladrón de Guevara,A, Ruiz Zafra,J, Sánchez-Palencia Ramos,A, Giraldo-Ospina,CF, Navajas Gómez,JA] Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain. [Ortega,FG, Puche,JL, de Miguel-Pérez,D, Lorente,JA, Serrano,MJ] GENYO, Centre for Genomics and Oncological Research (Pfizer / University of Granada / Andalusian Regional Government, Granada, Spain. [Puche,JL, Serrano,MJ] Integral Oncology Division, San Cecilio Clinical University Hospital, Granada, Spain. [Delgado-Rodriguez,M] Division of Preventive Medicine and Public Health, CIBERESP, University of Jaén, Jaén, Spain. [Lorente,JA] Laboratory of Genetic Identification, Department of Legal Medicine, University of Granada, Granada, Spain., and This work was supported by Fundacion de Investigacion Basica Alenjando Otero (www.Fibao.es)(MJS).
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0301 basic medicine ,Oncology ,Male ,Lung Neoplasms ,Physiology ,Cancer Treatment ,lcsh:Medicine ,Gastroenterology ,Lung and Intrathoracic Tumors ,Cohort Studies ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,0302 clinical medicine ,Circulating tumor cell ,Surgical oncology ,Carcinoma, Non-Small-Cell Lung ,Estudios prospectivos ,Medicine and Health Sciences ,Epidermal growth factor receptor ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,lcsh:Science ,Aged, 80 and over ,Recurrencia local de neoplasia ,Diseases::Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms::Bronchial Neoplasms::Carcinoma, Bronchogenic::Carcinoma, Non-Small-Cell Lung [Medical Subject Headings] ,Multidisciplinary ,biology ,Pronóstico ,Hematology ,Middle Aged ,Neoplastic Cells, Circulating ,Prognosis ,Body Fluids ,Humanos ,ErbB Receptors ,Surgical Oncology ,Blood ,030220 oncology & carcinogenesis ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk [Medical Subject Headings] ,Keratins ,Female ,Anatomy ,Research Article ,Adult ,medicine.medical_specialty ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings] ,Surgical and Invasive Medical Procedures ,Carcinoma de pulmón de células no pequeñas ,Riesgo ,03 medical and health sciences ,Diagnostic Medicine ,Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Transferases::Phosphotransferases::Phosphotransferases (Alcohol Group Acceptor)::Protein Kinases::Protein-Tyrosine Kinases::Receptor Protein-Tyrosine Kinases::Receptor, Epidermal Growth Factor [Medical Subject Headings] ,Internal medicine ,Análisis multivariante ,medicine ,Carcinoma ,Biomarkers, Tumor ,Humans ,Supervivencia sin enfermedad ,Radical surgery ,Lung cancer ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Disease-Free Survival [Medical Subject Headings] ,Radical Surgery ,Aged ,Receptor del factor de crecimiento epidérmico ,Surgical Resection ,business.industry ,lcsh:R ,Cancer ,Cancers and Neoplasms ,Biology and Life Sciences ,Diseases::Neoplasms::Neoplastic Processes::Neoplasm Recurrence, Local [Medical Subject Headings] ,medicine.disease ,Non-Small Cell Lung Cancer ,030104 developmental biology ,biology.protein ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings] ,lcsh:Q ,Neoplasm Recurrence, Local ,business - Abstract
Background Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC) stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs) is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC. Patients and Methods 56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR) expression. Results 51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1%) (p = 0.035). The mean number of CTCs was 3.16 per 10 ml (range 0–84) preoperatively and 0.66 (range 0–3) in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018) and a shorter disease free survival (DFS) (p = .008). In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50–21.946, p = 0.010) and N status (HR = 0.296, 95% CI: 0.091–0.961, p = 0.043) were independent prognostic factors for DFS. Conclusion CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence.
- Published
- 2016