Clinical Significance Of Detection Of Circulating Tumor Cells In Patients With Early Stage Lung Adenocarcinoma

Objective: Lung cancer is one of the main causes of death of all cancers worldwide. Non small cell lung cancer accounts for 85% to 90% of lung cancer patients. Lung adenocarcinoma, which accounts for about 50% of all lung cancer, continues to increase.The treatment of lung adenocarcinoma is based on the TNM stage as a guide, but the survival rate of patients with early stage lung adenocarcinoma is still not significantly improved.The reasons of the poor prognosis have been linked with distant metastases. Some studies have shown that circulating tumor cells were found in the blood of patients with early stage lung adenocarcinoma.Circulating tumor cells are tumor cells from the primary tumor entity or metastasis shed into the blood, it makes the risk of metastasis and recurrence was significantly increased. There is still controversy over whether adjuvant chemotherapy is required for IB stage lung cancer at present. NCCN think surgery in patients with lung adenocarcinoma after IB stage period do not recommend routine adjuvant chemotherapy and IB stage with low differentiation, tumor diameter >4cm, wedge factors such as the patients should be treated with adjuvant chemotherapy, but these risk factors and no circulation of EBM evidence.Circulating tumor cells have been identified as independent factors that affect metastasis and recurrence.Some study found that patients with stage IIA lung adenocarcinoma may benefit from postoperative chemotherapy,The research by stage IB and stageIIA lung adenocarcinoma patients after comparison of circulating tumor cells, To investigate the clinical significance of detection of circulating tumor cells in patients with early stage lung adenocarcinoma.Methods: 30 cases of patients with complete resection of lung adenocarcinoma from April 2015 to June 2015 in Fourth, hebei medical university hospital were selected as the research objects, Among them, 19 cases were stage IB, 11 cases were IIA stage, Detection and analysis of CTCs in blood samples using standardized and automated cell search systems,Compare the positive rate and the count of CTCs in patients with stage IB and IIA stage lung adenocarcinoma. The pathology, clinical data and EGFR findings of 30 patients were collected.The positive rate of CTCs in 30 patients combined with characteristics and high risk factors affecting postoperative recurrence and metastasis of lung cancer were compared.At the same time, the relationship between EGFR gene mutation and the positive rate of CTCs was compared by using the exact probability method.Results:1 19 cases of CTCs stage IB lung adenocarcinoma patients with positive 5, positive rate was 26.3%, 11 cases of CTCs stage IIA lung adenocarcinoma patients with positive 6, positive rate was 54.5%. Statistical analysis showed that there was no significant difference in the positive rates of IB between the CTCs phase and the IIA stage lung adenocarcinoma patients(p=0.238).2 There was no significant difference in the counts of circulating tumor cells in patients with stage IIA and stage IB lung adenocarcinoma after complete resection(p=0.140)(Table 1).3 30 cases of lung cancer patients in gender, age, smoking history, the degree of pathological differentiation, tumor where pulmonary lobectomy, carcinoembryonic antigen, visceral pleural invasion, operation etc. factors on CTCs positive rate showed no statistical significance(Table2).4 EGFR gene mutations occurred in 11 cases of CTCs positive patients with lung adenocarcinoma after surgery, and the difference was statistically significant between EGFR positive patients and CTCs positive rate in the patients with gene mutation(p=0.047)(Table3).Conclusion:1 there is no difference in the positive rate of CTCs in patients with stage IBand IIA stage lung adenocarcinoma, There was no significant difference in the possibility of metastasis of IIAstage patients with positive circulating tumor cells in patients with stage I B lung adenocarcinoma.2 CTCs the independent prognostic risk factors and differences in 30 cases of lung cancer patients in gender, age, smoking history, the degree of pathological differentiation, tumor where pulmonary lobectomy, carcinoembryonic antigen, visceral pleural invasion, operation etc. factors on CTCs positive rate of no statistical significance, the early stage lung adenocarcinoma patients with posterior circulation tumor cells(CTCs) positive as adjuvant chemotherapy are important factors to consider.3 The difference of CTCs positive rate between EGFR gene mutation positive patients and gene mutation negative patients was statistically significant.