小柯机器人

英国曼彻斯特大学Caroline Dive、Ged Brady和伦敦大学学院Charles Swanton等研究人员合作，发现了出现在肿瘤切除和疾病复发前的肺静脉循环肿瘤细胞扩散。相关论文2019年10月7日在线发表于《自然—医学》。

研究人员介绍，约有50％接受根治性手术的早期非小细胞肺癌（NSCLC）患者将在5年内复发。手术时对循环肿瘤细胞（CTC）的检测可能作为一种可用于识别复发风险较高的患者的工具，从而可建议对其进行更频繁的监测。

研究人员希望了解在早期NSCLC手术切除中CellSearch检测到的肺静脉CTC（PV-CTC）是否代表引起随后疾病复发的亚克隆。参与TRACERx研究的100名患者中有48％检测到PV-CTC，与肺癌特异性复发相关，并且在针对肿瘤阶段进行调整的多变量分析中，PV-CTC仍是复发的独立预测因子。在一项案例研究中，在手术中收集到的单个PV-CTC的基因组分析显示，与原发肿瘤（79％）相比，在10个月后发现的转移灶中有更高的突变重叠（91％），这提示早期传播的PV-CTC参与疾病复发。总之，PV-CTC结果和基因组图谱突显了PV-CTC作为手术后NSCLC复发的早期预测指标的潜力。然而，PV-CTC在预测复发中有限的灵敏度表明，有必要使用更大的独立研究队列进行进一步的研究，以确认并更好地定义PV-CTC在早期NSCLC中的潜在临床应用。

附：英文原文

Title: Pulmonary venous circulating tumor cell dissemination before tumor resection and disease relapse

Author: Francesca Chemi, Dominic G. Rothwell, Nicholas McGranahan, Sakshi Gulati, Chris Abbosh, Simon P. Pearce, Cong Zhou, Gareth A. Wilson, Mariam Jamal-Hanjani, Nicolai Birkbak, Jackie Pierce, Chang Sik Kim, Saba Ferdous, Deborah J. Burt, Daniel Slane-Tan, Fabio Gomes, David Moore, Rajesh Shah, Maise Al Bakir, Crispin Hiley, Selvaraju Veeriah, Yvonne Summers, Philip Crosbie, Sophia Ward, Barbara Mesquita, Marek Dynowski, Dhruva Biswas, Jonathan Tugwood, Fiona Blackhall, Crispin Miller, Allan Hackshaw, Ged Brady, Charles Swanton, Caroline Dive

Issue&Volume: 2019-10-07

Abstract: Approximately 50% of patients with early-stage non-small-cell lung cancer (NSCLC) who undergo surgery with curative intent will relapse within 5 years1,2. Detection of circulating tumor cells (CTCs) at the time of surgery may represent a tool to identify patients at higher risk of recurrence for whom more frequent monitoring is advised. Here we asked whether CellSearch-detected pulmonary venous CTCs (PV-CTCs) at surgical resection of early-stage NSCLC represent subclones responsible for subsequent disease relapse. PV-CTCs were detected in 48% of 100 patients enrolled into the TRACERx study3, were associated with lung-cancer-specific relapse and remained an independent predictor of relapse in multivariate analysis adjusted for tumor stage. In a case study, genomic profiling of single PV-CTCs collected at surgery revealed higher mutation overlap with metastasis detected 10 months later (91%) than with the primary tumor (79%), suggesting that early-disseminating PV-CTCs were responsible for disease relapse. Together, PV-CTC enumeration and genomic profiling highlight the potential of PV-CTCs as early predictors of NSCLC recurrence after surgery. However, the limited sensitivity of PV-CTCs in predicting relapse suggests that further studies using a larger, independent cohort are warranted to confirm and better define the potential clinical utility of PV-CTCs in early-stage NSCLC. Pulmonary venous tumor cells disseminating before tumor resection are heterogeneous, predict relapse and seed future metastasis of lung cancer

DOI: 10.1038/s41591-019-0593-1

Source:https://www.nature.com/articles/s41591-019-0593-1

Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
官方网址：https://www.nature.com/nm/
投稿链接：https://mts-nmed.nature.com/cgi-bin/main.plex