Dynamic Monitoring Of Circulating Tumor Cells For Advanced Primary Lung Cancer As Clinical Aplication Research

Objective:This study examined the changes in circulating tumor cells(CTCs) before and after chemotherapy inpatients with advanced lung cancer, analyzed the relationship of CTCs with age, gender, smoking,histological type, degree of differentiation and clinical stage, preliminarily evaluate the relevance of CTCsfor clinical feature and efficacy, further investigate the clinical application value of CTCs.Methods:Detecting the levels of CTCs in40advanced lung cancer patients’ peripheral blood before and afterchemotherapy by density gradient centrifugation method and immunofluorescence method, and taking10cases of lung benign disease patients and10cases of healthy volunteers as control.Results:1.The positive rate of CTC is57.5%in40advanced lung cancer patients before chemotherapy and0%in the control group respectively, being a significant difference (P<0.001).2.The positive rate of CTCs and the age, gender, smoking, histological type, the degree ofdifferentiation for patients with advanced lung cancer were not statistically significant(P>0.05). Thepositive rate of CTCs (78.9%) for lung cancer patients of stage IV were significantly higher than stage III(38.1%), the difference was statistically significant (P=0.01).3.23cases of lung cancer patients CTCs detection positive before chemotherapy,14cases afterchemotherapy, CTCs detection results were significantly different before and after chemotherapy (P<0.05).4.Compared with lung cancer patients before chemotherapy, the number of CTCs increased,unchangedand decreased after one chemotherapy cycle were7cases,25cases and8cases, respectively. Then aftertwo cycles of chemotherapy, the results of efficacy evaluation for PR, SD and PD by imaging were8cases,26cases and6cases, respectively. The correlation analysis showed that it was negative correlation betweenthe CTCs number and clinical efficacy(r=-0.346, P=0.029).5.The median PFS was5.0months and8.2months(χ2=8.832, P=0.003) for patients with CTCs-positive and CTCs-negative, respectively.Conclusion:1.There were significant differences for the positive rate of CTCs between lung cancer and non-lungcancer patients, and the positive rate of CTCs was related to distant metastasis and TNM stage, which wasnot correlated to age, gender, smoking status, pathological type and degree of differentiation.2.The number of CTCs before and after treatment were related to clinical efficacy, we can predict theefficacy of chemotherapy in patients with advanced lung cancer by testing CTCs.3.CTCs-positive have shorter median PFS than CTCs-negative in advanced lung cancer patients,prompting that CTCs may be a poor prognostic factor.