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Front. Oncol. | doi: 10.3389/fonc.2019.01139

Detection of circulating tumor cell molecular subtype in pulmonary vein predicting prognosis of stage I-III non-small cell lung cancer patients

Jingsi Dong1,  Daxing Zhu1, Xiaojun Tang1, Xiaoming Qiu1, Dan Lu1,  Bingjie Li1, Dan Lin1 and  Qinghua Zhou1*
  • 1West China Hospital, Sichuan University, China

Background: There was rare studies on prognosis of pulmonary venous CTC and early or advanced NSCLC patients. We want to investigate whether CTCs and the subtype of it can predict the prognosis of NSCLC patients.
Patients and methods: 114 patients with stage I-III NSCLC were included CanPatrolTM CTC analysis. PD-L1 expression level were detected in CTC of pulmonary vein. PD-L1, number of CTC in pulmonary, CTC’s subtype, clinical characteristics, prognosis of patients were analyzed.
Results: 110/114 (96.5%) patients could be found CTCs in pulmonary vein, 58/114 (50.9%) patients had CTC≥15/ml in pulmonary vein, 53/110 patients (48.2%) were defined as having MCTC subtype and 56/110 patient were found have PD-L1 (+) CTC in pulmonary vein. Multivariate analyses showed that PVCTC, MCTC and stage were independent factors of DFS (P <0.05). No OS difference was found between number of CTC (P =0.33) and other CTC factors (P >0.05), only stage was independent factor of OS(P =0.019). There were decreases of CTC number and MCTC number in EGFR mutant subgroup (P=0.0009 and P =0.007). There were increases of CTC (P =0.0217), MCTC (P =0.0041) and PD-L1 (+) CTC (P =0.0002) number in KRAS mutant subgroup. There was increase of MCTC (P =0.0323) number in BRAF mutant. There were fewer CTCs in pulmonary vein for patients with EGFR mutant than in patients with full wild-type gene(P =0.0346). There were more PD-L1 positive CTCs in pulmonary vein for patients with ALK rearrangement, KRAS mutant, BRAF mutant or ROS1 mutant than in patients with full wild-type gene (P =0.0610, P =0.0003, P =0.032 and P =0.0237 ). There were more mesenchymal CTCs in pulmonary vein for patients with KRAS mutant and BRAF mutant than in patients with full wild-type gene (P =0.073 and P =0.0381). There were fewer mesenchymal CTCs in pulmonary vein for patients with EGFR mutant than in patients with full wild-type gene (P =0.0898).
Conclusions: The patients with high number of CTCs, MCTCs or PD-L1 (+) CTCs in pulmonary vein experienced poor prognosis of DFS. There are obvious correlations between the CTC subtype of NSCLC and the gene subgroups of tumor tissue.

Keywords: Pulmonary vein, CTC (circulation tumor cells), NSCLC - lung adenocarcinoma - EGFR - ALK - BRAF - KRAS - RET - MET - PD-L1 - ROS1., PD-L1, EMT - epithelial to mesenchymal transition

Received: 18 Jul 2019; Accepted: 11 Oct 2019.

Copyright: © 2019 Dong, Zhu, Tang, Qiu, Lu, Li, Lin and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Qinghua Zhou, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China,