Cluster circulating tumor cells in surgical cases of lung cancer
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ORIGINAL ARTICLE
Cluster circulating tumor cells in surgical cases of lung cancer Noriyoshi Sawabata1,2 · Yoshiyuki Susaki1 · Takahito Nakamura1 · Takeshi Kawaguchi2 · Motoaki Yasukawa2 · Shigeki Taniguchi2 Received: 24 December 2019 / Accepted: 29 January 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objectives A cancer lesion sheds tumor cells into the circulating blood as circulating tumor cells (CTCs). Since cluster CTCs have been considered as precursor lesions of metastasis, their clinical implication was investigated in this study according to the preoperative status of cluster CTC detection in surgical cases of clinically early-stage lung cancer. Methods Among 104 surgical patients of early-stage lung cancer, CTCs were extracted from the peripheral blood before surgery using a micro-pore size selection method ( ScreenCell®) and diagnosed microscopically. Implications of detecting cluster CTC were assessed according to the prognosis and clinicopathological characteristics. Results The status of CTC detection was not detected in 77 cases (74.0%), single CTC only detection in 7 cases (6.7%), and cluster CTC detected in 20 cases (19.2%). Patients with cluster CTCs exhibited significantly lower recurrence-free survival and overall survival than did patients of other groups. In addition, in hazard ratio analysis, the hazard ratios were independent of other predictors of poor prognosis, and detection of cluster CTCs was associated with predictors of poor prognosis. Conclusion Cluster CTCs were detected in cases where the original lung cancer lesion had clinical predictors of poor prognosis and were independent negative predictors of survival. Keywords Circulating tumor cell · Lung cancer · Surgery
Introduction Lung cancer is currently the leading cause of cancer-related deaths worldwide [1]. Notwithstanding advances in diagnostic strategies and treatment, lung cancer still has a poor prognosis [2]. Among surgical patients of early-stage lung cancer, there is a possibility of potentially advanced cancer. As such, the development of less invasive new techniques to diagnose tumorigenesis of lung cancer contributes to improving the prognosis. A cancer lesion dislodges tumor cells into circulating blood as CTCs [3]. Above all, cluster CTCs have been This paper was presented at the 55th annual meeting of The Society of Thoracic Surgeons, San Diego, USA. * Noriyoshi Sawabata [email protected] 1
Respiratory Disease Center, Hoshigaoka Medical Center, 4‑8‑1 Hoshigaoka, Hirakata City, Osaka 573‑8511, Japan
Department of Thoracic and Cardio‑Vascular Surgery, Nara Medical University, 840 Shijo‑cho, Kashihara City, Nara 634‑8522, Japan
2
considered precursor lesions of metastasis due to their properties of longevity, self-movement, and high potential of tumorigenesis; consequently, cluster CTCs are responsible for the metastatic potential [3, 4]. Thus, clinical implications of cluster CTCs were investigated using the preoperative status of CTC detection in surgical cases of lung can
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