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Correlations between circulating tumor cell phenotyping and 18F-fluorodeoxyglucose positron emission tomography uptake in non-small cell lung cancer

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The epithelial-to-mesenchymal transition (EMT) phenotype-based subsets of circulating tumor cells (CTCs) might be predictors of tumor progression. We evaluated the clinical properties of different phenotypic CTCs in patients with non-small cell lung cancer (NSCLC). Secondly, we explored the association between different phenotypic CTCs and the uptake of 18F-fluorodeoxyglucose (FDG) by the primary tumor on a positron emission tomographic (PET) scan.

Methods

Venous blood samples from 34 pathologically confirmed Stage IIB-IVB NSCLC patients were collected prospectively. CTCs were immunoassayed using a SE-i·FISH®CTC kit. We identified CTCs into cytokeratin positive (CK+) and cytokeratin negative (CK−) phenotypes. CTC classifications were correlated with the maximum standardized uptake value (SUVmax) measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Overall survival (OS) and progression-free survival (PFS) curves were produced using the Kaplan–Meier method.

Results

CTCs were detected in 91.2% of NSCLC patients. CTC counting was associated with TNM stage (P = 0.014) and distant metastasis (P = 0.007). The number of CK−CTCs was also positively associated with TNM stage (P = 0.022) and distant metastasis (P = 0.007). Both total CTC counting and CK−CTC counting did not show association with SUVmax value (P = 0.959, P = 0.903). Kaplan–Meier survival analysis demonstrated that patients with ≥ 7 CTCs had shorter OS (P = 0.003) and PFS (P = 0.001) relative to patients with < 7 CTCs). Notably, the number of CK−CTCs can act as independent risk factors for PFS (P = 0.044) and OS (P = 0.043) in NSCLC patients. However, SUVmax value was not associated with OS (P = 0.895) and PFS (P = 0.686).

Conclusion

The CTC subpopulations could be useful evidence for testing metastasis and prognosis in NSCLC patients. The SUVmax value of the primary tumor was not related to prognosis in patients with NSCLC.

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Funding

This study was supported by grants from the Natural Science Fund of Yangzhou City (Nos. YZ2017114, YZ2017121).

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Author notes

  1. Jiarong Bian and Ke Yan contributed equally to this work.

Authors and Affiliations

  1. Department of Respiratory Medicine, Northern Jiangsu Province Hospital, Clinical Medical College of Yangzhou University, 28 Nan Tong Road, Yangzhou, 225001, People’s Republic of China

    Jiarong Bian, Na Liu & Xingxiang Xu

  2. Department of Neurosurgery, Northern Jiangsu Province Hospital, Clinical Medical College of Yangzhou University, Yangzhou, 225001, People’s Republic of China

    Ke Yan

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  1. Jiarong Bian
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  2. Ke Yan
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  3. Na Liu
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Contributions

XXX conceived and directed this study. XXX, JRB, KY and NL performed the experiments and acquired the data. XXX, JRB and NL analyzed and interpreted the data. JRB and KY wrote and revised the manuscript. All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work is appropriately investigated and resolved.

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Correspondence to Xingxiang Xu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Bian, J., Yan, K., Liu, N. et al. Correlations between circulating tumor cell phenotyping and 18F-fluorodeoxyglucose positron emission tomography uptake in non-small cell lung cancer. J Cancer Res Clin Oncol 146, 2621–2630 (2020). https://doi.org/10.1007/s00432-020-03244-4

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