Dynamically monitoring minimal residual disease using circulating tumour cells to predict the recurrence of early-stage lung adenocarcinoma

IF 29.5 1区 医学 Q1 HEMATOLOGY
Qi Zhang, Xiaoli Zhang, Zhuoheng Lv, Huandong Huo, Ligong Yuan, Duo Wan, Peipei Xie, Shujun Cheng, Kaitai Zhang, Wen Zhang, Yousheng Mao
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引用次数: 0

Abstract

Lung adenocarcinoma (LUAD) is one of the leading causes of cancer-related deaths worldwide, with a 5-year survival rate of approximately 19%. With the advent of screening and diagnostic techniques such as low-dose spiral CT and liquid biopsy, the detection rate of early stage LUAD is increasing. Even in stage I LUAD, the cumulative 5-year recurrence rate after radical surgical resection is 17.9%. This may be related to the presence of microscopic residual disease (MRD), a potential source of recurrence and metastasis. Circulating tumour cells (CTCs) are key biomarkers in liquid biopsies, but the ability of dynamic CTC detection to monitor MRD and warn of recurrence in patients with early LUAD has not been validated. Here, we conducted a prospective study using the telomerase reverse transcriptase-based CTC detection method (TBCD) to evaluate perioperative and follow-up CTC levels for dynamic monitoring to evaluate its clinical efficacy in predicting postoperative recurrence in early-stage LUAD. By longitudinal dynamic monitoring of CTC, we accurately predicted recurrence within 2 years after surgery, with an AUC of 0.9786, demonstrating the clinical values of CTC in predicting recurrence. The median lead time from positive detection of CTC to radiological recurrence was 183 days, with the earliest CT recurrence predicted 354 days in advance. Taken together, our study demonstrates that longitudinal monitoring of CTC is effective in early warning of LUAD recurrence and provides valuable information on early detection and intervention strategies for the management of LUAD.
利用循环肿瘤细胞动态监测极小残留病变,预测早期肺腺癌的复发情况
肺腺癌(LUAD)是全球癌症相关死亡的主要原因之一,5 年生存率约为 19%。随着低剂量螺旋 CT 和液体活检等筛查和诊断技术的出现,早期 LUAD 的检出率不断提高。即使是 I 期 LUAD,根治性手术切除后的 5 年累计复发率也高达 17.9%。这可能与微小残留病(MRD)的存在有关,MRD是复发和转移的潜在来源。循环肿瘤细胞(CTC)是液体活检的关键生物标记物,但动态CTC检测监测MRD和预警早期LUAD患者复发的能力尚未得到验证。在此,我们开展了一项前瞻性研究,使用基于端粒酶逆转录酶的 CTC 检测方法(TBCD)评估围手术期和随访的 CTC 水平,进行动态监测,以评估其在预测早期 LUAD 术后复发方面的临床疗效。通过纵向动态监测 CTC,我们准确预测了术后 2 年内的复发,AUC 为 0.9786,证明了 CTC 在预测复发方面的临床价值。从 CTC 阳性检测到放射学复发的中位提前期为 183 天,最早的 CT 复发提前了 354 天。综上所述,我们的研究表明,CTC 的纵向监测能有效预警 LUAD 复发,并为 LUAD 的早期检测和干预策略提供有价值的信息。
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来源期刊
CiteScore
48.10
自引率
2.10%
发文量
169
审稿时长
6-12 weeks
期刊介绍: The Journal of Hematology & Oncology, an open-access journal, publishes high-quality research covering all aspects of hematology and oncology, including reviews and research highlights on "hot topics" by leading experts. Given the close relationship and rapid evolution of hematology and oncology, the journal aims to meet the demand for a dedicated platform for publishing discoveries from both fields. It serves as an international platform for sharing laboratory and clinical findings among laboratory scientists, physician scientists, hematologists, and oncologists in an open-access format. With a rapid turnaround time from submission to publication, the journal facilitates real-time sharing of knowledge and new successes.
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