循环肿瘤细胞团和循环肿瘤血管内皮细胞团在小细胞肺癌预后评估中的价值OA

OBJECTIVE:This study aimed to detect circulating tumor cell microemboli(CTM)and circulating tumor endothelial microemboli(CTEM)in the peripheral blood of small cell lung cancer(SCLC)patients and to evaluate their clinicopathological and prognostic significance.METHODS:Blood samples of 120 newly diagnosed SCLC patients were prospectively collected.Subtraction enrichment and immunostaining-fluorescence in situ hybridization(SE-iFISH)was applied to detect circulating tumor cells(CTCs),circulating tumor endothelial cells(CTECs),CTM and CTEM.RESULTS:Before treatment,the positive rates of CTCs and CTECs in the peripheral blood of SCLC patients were 94.17%and 83.33%,respectively,while the positive rates of CTM and CTEM were 15.8%and 8.3%,respectively.Patients with extensive-stage SCLC exhibited a significantly higher CTEM positivity rate of 13.85%compared with 1.82%in those with limited-stage SCLC(P=0.041).Likewise,the positivity rates of CTM and CTEM were 35%and 25%,respectively,in patients with liver metastases before treatment,which were significantly higher than those(12%and 5%)in patients without liver metastases(both P<0.01).The objective response rate was 14.28%for CTEM-positive patients,which was significantly lower than 68.18%for CTEM-negative patients(P=0.014).Survival analysis revealed that SCLC patients with pre-treatment CTEM had significantly shorter progression-free survival and overall survival compared to those without CTEM(both P<0.05).CONCLUSION:In pre-treatment SCLC patients,positive detection of CTEM was associated with advanced disease stage and liver metastasis.Our observations may serve as a predictor of inferior treatment response and unfavorable prognosis,providing an easy and feasible biomarker for clinical practice.