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Characteristics of circulating tumor cells in organ metastases, prognosis, and T lymphocyte mediated immune response

Authors Sun WW, Xu ZH, Lian P, Gao BL, Hu JA

Received 13 December 2016

Accepted for publication 21 February 2017

Published 4 May 2017 Volume 2017:10 Pages 2413—2424


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 3

Editor who approved publication: Dr Carlos E Vigil

Wen-Wen Sun,1,* Zhi-Hong Xu,1,* Peng Lian,1 Bei-Li Gao,2 Jia-An Hu1

1Department of Geriatrics, 2Department of Respiration, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Abstract: Circulating tumor cells (CTCs) possess profound influence on tumor metastases and disease progression. This study aimed to investigate the correlation of CTCs with clinical characteristics and T-cell immunity, and to explore whether CTCs and the subpopulations can serve as an independent prognostic factor in advanced non-small cell lung cancer (NSCLC). A prospective study was conducted in late stages of NSCLC patients. The levels of overall CTCs and the three subpopulation CTCs were enumerated using the CanPatrol™ CTC enrichment system. The information about the patients which included the clinical characteristics, survival status at the 200th day postdiagnosis, and the levels of T cells was collected. Mann–Whitney U test, Kruskal–Wallis H test, Cox regression, and Spearman’s rank correlation coefficient were the statistical methods used in this study. We detected CTCs in 27 of the 31 eligible patients; the level of epithelial–mesenchymal circulating tumor cells (EMCTCs) was higher than that of epithelial circulating tumor cells and that of mesenchymal circulating tumor cells (MCTCs) in the majority of NSCLC patients. Organ metastases were positively associated with the levels of overall CTCs, EMCTCs, and MCTCs (P<0.05). EMCTCs and MCTCs were associated with worse clinical outcomes. Additionally, the levels of EMCTCs were negatively associated with the levels of CD3+ T cells (P=0.01) and CD8+ T cells (P=0.04). In conclusion, the levels of CTCs were positively associated with organ metastases, particularly bone metastases, but were negatively associated with T-cell levels. The levels of EMCTCs and MCTCs had negative prognostic value.

Keywords: clinical trial, non-small cell lung cancer, circulating tumor cells, organ metastases, prognosis, lymphocyte T immune system

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