Frequency of Circulating Tumor Cells (CTC) in Patients with Brain Metastases: Implications as a Risk Assessment Marker in Oligo-Metastatic Disease
Frequency of Circulating Tumor Cells (CTC) in Patients with Brain Metastases: Implications as a Risk Assessment Marker in Oligo-Metastatic Disease
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DOI：
10.3390/cancers10120527
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发表时间：
2018-12-01
期刊：
影响因子：
5.2
通讯作者：
Wikman, Harriet
中科院分区：
文献类型：
--
作者：
Hanssen, Annkathrin;Riebensahm, Carlotta;Wikman, Harriet
40%的非小细胞肺癌（NSCLC）患者发生脑转移，导致预后不良。然而，患者在寡转移性脑疾病设置似乎有更好的结果。在这里，我们研究了使用循环肿瘤细胞（CTC）作为生物标志物来区分寡转移患者以进行更好的风险评估的可能性。使用CellSearch（R）系统，在具有脑转移的NSCLC患者（n = 52，12.5% >= 2和8.9% >= 5个CTC/7.5mL血液）中检测到很少的CTC，特别是寡转移脑患者（n = 34，5.9%和2.9%）。尽管如此，在所有NSCLC患者中，>= 2和>= 5个CTC的阈值是缩短总生存时间的独立预后指标（n = 90，2个CTC >= HR：1.629，p = 0.024，95%CI：1.137-6.465和5个CTC >= HR：2.846，p = 0.0304，CI：1.104-7.339），以及脑转移患者（两个CTC >= HR：4.694，p = 0.004，CI：1.650-13.354，和五个CTC >= HR：4.963，p = 0.003，CI：1.752-14.061）。此外，具有CTC的寡聚脑转移性NSCLC患者的预后非常差（p = 0.019）。同样，在其他肿瘤实体中，仅9.6%的脑转移患者（n = 52）可检测到CTC。我们的数据表明，尽管脑转移患者很少携带CTC，但它们仍然可以预测总生存期，CTC可能是一种有用的生物标志物，用于识别可能从更强的治疗中获益的寡转移性NSCLC患者。
Forty percent of non-small cell lung cancer (NSCLC) patients develop brain metastases, resulting in a dismal prognosis. However, patients in an oligo-metastatic brain disease setting seem to have better outcomes. Here, we investigate the possibility of using circulating tumor cells (CTCs) as biomarkers to differentiate oligo-metastatic patients for better risk assessment. Using the CellSearch (R) system, few CTCs were detected among NSCLC patients with brain metastases (n = 52, 12.5% >= two and 8.9% >= five CTC/7.5 mL blood) and especially oligo-metastatic brain patients (n = 34, 5.9%, and 2.9%). Still, thresholds of both >= two and >= five CTCs were independent prognostic indicators for shorter overall survival time among all of the NSCLC patients (n = 90, two CTC >= HR: 1.629, p = 0.024, 95% CI: 1.137-6.465 and five CTC >= HR: 2.846, p = 0.0304, CI: 1.104-7.339), as well as among patients with brain metastases (two CTC >= HR: 4.694, p = 0.004, CI: 1.650-13.354, and five CTC >= HR: 4.963, p = 0.003, CI: 1.752-14.061). Also, oligo-brain NSCLC metastatic patients with CTCs had a very poor prognosis (p = 0.019). Similarly, in other tumor entities, only 9.6% of patients with brain metastases (n = 52) had detectable CTCs. Our data indicate that although patients with brain metastases more seldom harbor CTCs, they are still predictive for overall survival, and CTCs might be a useful biomarker to identify oligo-metastatic NSCLC patients who might benefit from a more intense therapy.