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Open AccessArticle

Circulating Tumor Cells as a Tool of Minimal Residual Disease Can Predict Lung Cancer Recurrence: A longitudinal, Prospective Trial

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Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
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College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
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Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 112304, Taiwan
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Department of Medical Research, Taichung Veterans General Hospital, Taichung 407752, Taiwan
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Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407752, Taiwan
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Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
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Circulating Tumor Cell Lab., Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(3), 144; https://doi.org/10.3390/diagnostics10030144
Received: 27 January 2020 / Revised: 27 February 2020 / Accepted: 5 March 2020 / Published: 6 March 2020
(This article belongs to the Section Pathology and Molecular Diagnostics)
Background: The role of circulating tumor cells (CTCs) for predicting the recurrence of cancer in lung cancer patients after surgery remains unclear. Methods: A negatively selected protocol of CTC identification was applied. For all the enrolled patients, CTC testing was performed before and after surgery on the operation day (day 0), postoperative day 1, and day 3. The daily decline and trend of CTCs were analyzed to correlate with cancer relapse. The mixed model repeated measures (MMRM) adjusted by cancer characteristics was applied for statistical significance. Results: Fifty patients with lung mass undergoing surgery were enrolled. Among 41 primary lung cancers, 26 (63.4%) were pathological stage Tis and I. A total of 200 CTC tests were performed. MMRM analysis indicated that surgery could contribute to a CTC decline after surgery in all patients with statistical significance (p = 0.0005). The daily decrease of CTCs was statistically different between patients with and without recurrence (p = 0.0068). An early rebound of CTC counts on postoperative days 1 and 3 was associated with recurrence months later. Conclusion: CTC testing can potentially serve as a tool for minimal residual disease detection in early-staged lung cancer after curative surgery. View Full-Text
Keywords: non-small cell lung cancer; early-stage; circulating tumor cells; early detection; minimal residual disease’ mixed model repeated measures non-small cell lung cancer; early-stage; circulating tumor cells; early detection; minimal residual disease’ mixed model repeated measures
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Wu, C.-Y.; Lee, C.-L.; Wu, C.-F.; Fu, J.-Y.; Yang, C.-T.; Wen, C.-T.; Liu, Y.-H.; Liu, H.-P.; Hsieh, J. .-H. Circulating Tumor Cells as a Tool of Minimal Residual Disease Can Predict Lung Cancer Recurrence: A longitudinal, Prospective Trial. Diagnostics 2020, 10, 144.

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