Correlations between circulating tumor cell phenotyping and 18F-fluorodeoxyglucose positron emission tomography uptake i
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Correlations between circulating tumor cell phenotyping and 18F‑fluorodeoxyglucose positron emission tomography uptake in non‑small cell lung cancer Jiarong Bian1 · Ke Yan2 · Na Liu1 · Xingxiang Xu1 Received: 29 January 2020 / Accepted: 4 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The epithelial-to-mesenchymal transition (EMT) phenotype-based subsets of circulating tumor cells (CTCs) might be predictors of tumor progression. We evaluated the clinical properties of different phenotypic CTCs in patients with nonsmall cell lung cancer (NSCLC). Secondly, we explored the association between different phenotypic CTCs and the uptake of 18F-fluorodeoxyglucose (FDG) by the primary tumor on a positron emission tomographic (PET) scan. Methods Venous blood samples from 34 pathologically confirmed Stage IIB-IVB NSCLC patients were collected prospectively. CTCs were immunoassayed using a SE-i·FISH®CTC kit. We identified CTCs into cytokeratin positive ( CK+) and cytokeratin negative ( CK−) phenotypes. CTC classifications were correlated with the maximum standardized uptake value (SUVmax) measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Overall survival (OS) and progression-free survival (PFS) curves were produced using the Kaplan–Meier method. Results CTCs were detected in 91.2% of NSCLC patients. CTC counting was associated with TNM stage (P = 0.014) and distant metastasis (P = 0.007). The number of CK−CTCs was also positively associated with TNM stage (P = 0.022) and distant metastasis (P = 0.007). Both total CTC counting and C K−CTC counting did not show association with SUVmax value (P = 0.959, P = 0.903). Kaplan–Meier survival analysis demonstrated that patients with ≥ 7 CTCs had shorter OS (P = 0.003) and PFS (P = 0.001) relative to patients with 95%. Patients fasted for more than 6 h prior to the examination, and blood glucose was controlled below 7.0 mmol /l. The patient was intravenously injected with 18F-FDG 3.7 ~ 5.55 MBq/kg. The time between injection and acquisition ranged from 50 to 70 min. Scans included CT scans and PET acquisitions under calm breaths. The PET image was attenuated-corrected by CT scan data, and reconstructed by the method of the iterative reconstruction ordered subset maximum expected value. 18F-FDG PET/ CT image was performed form the skull base to the upper thigh. The maximum standardized uptake value (SUVmax) was recorded using volumetric region of interest and using the formula: the tissue concentration of 18F-FDG measured by PET/the injected dose/body weight.
Statistical analysis The data were expressed as medians and percentage. According to median, the data were divided into two groups. The data were not normally distributed, and the Mann–Whitney U test was used between two groups and the Kruskal–Wallis H test was used for multigroup analysis. PFS and OS were assessed using the Kaplan–Meier method and compared using the log-rank test. Cox regressi
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