ABSTRACT
No disponible
Subject(s)
Humans , Female , Young Adult , Thoracic Wall/diagnostic imaging , Neoplasms , Thoracic Wall/surgery , Chest PainSubject(s)
Melanoma , Pleural Neoplasms , Thoracic Neoplasms , Thoracic Wall , Humans , Melanoma/diagnostic imaging , Melanoma/pathology , Pleura/pathology , Pleural Neoplasms/diagnostic imaging , Pleural Neoplasms/pathology , Thoracic Neoplasms/diagnostic imaging , Thoracic Neoplasms/pathology , Thoracic Wall/diagnostic imaging , Thoracic Wall/pathologyABSTRACT
BACKGROUND: The prognosis of early stage non-small cell lung cancer (NSCLC) is quite disappointing and the benefits of adjuvant therapy are relatively small. Thus, there is an urgent need to identify novel prognostic and predictive biomarkers. Lung adenocarcinoma has distinct clinical-pathological characteristics and novel therapeutic strategies are under active evaluation in the adjuvant setting. Here, we investigated the prognostic impact of circulating tumor cells (CTCs) and gene and miRNA tissue expression in resectable NSCLC. PATIENTS AND METHODS: We assessed the association between CTC subpopulations and the outcome of resected early stage lung adenocarcinoma (ADC) patients at three different time-points (CTC1-3) (before surgery, after one month, and after six months) in comparison to squamous cell carcinoma (SCC). Furthermore, gene and miRNA tissue expression, immunoprofiling, and epithelial-to-mesenchymal transition (EMT) markers were correlated with outcome. RESULTS: ADC (n = 47) and SCC (n = 50) revealed different tissue expression profiles, resulting in the presence of different CTC subpopulations. In ADC, miR-155 correlated with AXL and IL6R expression, which were related to the presence of EMT CTC1 (p = 0.014 and p = 0.004). In the multivariate analysis, CTC2 was an independent prognostic factor for relapse-free survival, and CTC3 and AXL were independent prognostic for overall survival only in ADC. Neither the surgery nor the adjuvant treatment influenced the prognosis of these patients. CONCLUSIONS: Our study elucidate the prognostic impact of tissue AXL expression and the presence of CTCs after surgery in adenocarcinoma patients. Tissue AXL expression and CTC EMT activation could potentially represent biomarkers for the stratification of ADC patients that might benefit from new adjuvant therapies.
ABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Papilloma/surgery , Bronchial Neoplasms/diagnostic imaging , Papilloma/diagnostic imaging , Papilloma/etiology , Neoplasms, Glandular and Epithelial , Respiratory System/pathology , Tomography, Spiral Computed/methods , Diagnosis, Differential , Thoracoscopy/methods , Thoracic Surgery, Video-Assisted/methodsSubject(s)
Bronchial Neoplasms/surgery , Papilloma/surgery , Pneumonectomy , Female , Humans , Middle AgedSubject(s)
Aorta, Thoracic , Heart Neoplasms/diagnosis , Pulmonary Artery , Sarcoma, Synovial/diagnosis , Cardiac Surgical Procedures/methods , Echocardiography , Female , Heart Atria , Heart Neoplasms/surgery , Humans , Middle Aged , Positron-Emission Tomography , Sarcoma, Synovial/surgery , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Hemangioendothelioma/diagnostic imaging , Mediastinal Neoplasms/diagnostic imaging , Subclavian Vein/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Hemangioendothelioma/surgery , Subclavian Vein/pathology , Tomography, Emission-Computed , Length of StaySubject(s)
Head and Neck Neoplasms/diagnostic imaging , Hemangioendothelioma/diagnostic imaging , Mediastinal Neoplasms/diagnostic imaging , Subclavian Vein , Vascular Neoplasms/diagnostic imaging , Female , Head and Neck Neoplasms/pathology , Hemangioendothelioma/pathology , Humans , Mediastinal Neoplasms/pathology , Tumor Burden , Vascular Neoplasms/pathology , Young AdultABSTRACT
OBJECTIVES: More than 20% of lung cancer patients develop a recurrence, even after curative resection. We hypothesized that relapse may arise from the dissemination of circulating tumour cells (CTCs). This study evaluates the significance of CTC detection as regards the recurrence of non-small-cell lung cancer (NSCLC) in surgically resected patients. Secondly, we investigated the association between CTCs and the uptake of 18 F-fluorodeoxyglucose (FDG) by the primary tumour on a positron emission tomographic (PET) scan. METHODS: In this single-centre prospective study, blood samples for analysis of CTCs were obtained from 102 patients with Stage I-IIIA NSCLC both before (CTC1) and 1 month after (CTC2) radical resection. CTCs were isolated using immunomagnetic techniques. The presence of CTCs was correlated with the maximum standardized uptake value (SUVmax) measured on preoperative FDG PET/computed tomographic scans. Recurrence free survival (RFS) analysis was performed. RESULTS: CTCs were detected in 39.2% of patients before and in 27.5% 1 month after the operation. The presence of CTCs after the operation was significantly correlated with SUVmax on PET scans, pathological stage and surgical approach. Only SUVmax was an independent predictor for the presence of CTC2 on multivariate analysis. Postoperative CTCs were significantly correlated with a shorter RFS ( P = 0.005). In multivariate analysis, the presence of CTC2 was associated with RFS, independent of disease staging. CONCLUSIONS: Detection of CTCs 1 month after radical resection might be a useful marker to predict early recurrence in Stage I-III NSCLC. The SUVmax value of the primary tumour on preoperative PET scans was associated with the presence of CTC 1 month after the operation.