Circulating Tumor Cell as a Diagnostic Marker in Primary Lung Cancer

Abstract

Purpose: To investigate the diagnostic performance of circulating tumor cells (CTC) in discrimination between primary lung cancer and nonmalignant diseases as well as in prediction of distant metastasis. Patients and Methods: We prospectively evaluated CTCs in 7.5-mL samples of peripheral blood sampled from patients with a suspicion or a diagnosis of primary lung cancer. A semiautomated system was used to capture CTCs with an antibody against epithelial cell adhesion molecule. Results: Of 150 eligible patients, 25 were finally diagnosed as having nonmalignant disease, and 125 were diagnosed as having primary lung cancer with (n = 31) or without (n = 94) distant metastasis. CTCs were detected in 30.6% of lung cancer patients and in 12.0% of nonmalignant patients. CTC count was significantly higher in lung cancer patients than in nonmalignant patients, but a receiver operating characteristic (ROC) curve analysis showed an insufficient capability of the CTC test in discrimination between lung cancer and nonmalignant diseases with an area under ROC curve of 0.598 (95% confidence interval, 0.488-0.708; P = 0.122). Among lung cancer patients, CTC count significantly increased along with tumor progression, especially with development of distant metastasis. The area under ROC curve for CTC count in prediction of distant metastasis was 0.783 (95% confidence interval, 0.679-0.886; P < 0.001). When patients with one or more CTCs were judged as having metastatic disease, sensitivity and specificity of the CTC test were 71.0% and 83.0%, respectively. Conclusions: CTC is a useful surrogate marker of distant metastasis in primary lung cancer. (Clin Cancer Res 2009;15(22):6980-6)

Clinical Utility of Circulating Tumor Cells – A Clinician’s Current View

“…CTCS have been used to evaluate recurrence detection, prognosis, and treatment response in both SCLC and NSCLC. In diagnosed or suspected lung cancer (n = 150), a correlation between CTC count and extent of disease as patients' condition progressed was found consistent with results seen in other cancer subtypes [129]; 30.6% of lung cancer patients had identifiable CTCs. Most of the patients in this study were early stage cancer, with 110 patients out of 150 Stage I-IIIA.…”

Detection of minimal residual disease in lung cancer

“…Several studies [16][17][18][19][20][21][22][23][24][25] , published in this area with a focus on lung cancer, have provided knowledge of the clinical significance of tumor markers for the detection of MRD. Of these the most specific marker appears to be Lunx protein 16,17,25 , although some other markers appear to be applicable for MRD detection in lung cancer, especially CEA (ref.…”

“…The aim of Japanese authors led by Fumihury Tanaka in 2009 was to determine the prognostic significance of CTCs in the peripheral blood of patients with lung cancer, with non tumour disease and in patients with distant metastases 18 . They demonstrated a greater number of CTCs in patients with lung cancer, but this difference was not statistically significant.…”

Safety and Therapeutic Efficacy of the Lewis Y Carbohydrate Specific Humanized Antibody MB311 in Patients with Malignant Effusion

“…MB311 was well tolerated, permeated into malignant effusion and attracted immune cells leading to decreased tumor cell counts in the effusion. About 20 years ago, disseminated tumor cells were regarded as important marker [31] and have gained recently increasing attention and relevance as a diagnostic and prognostic factor in cancer therapy [32][33][34][35][36]. Notably, in the pt with the strongest LeY expression as well as concomitant Her2/ neu expression on the malignant cells in the effusion a dramatic effect on LeY, EpCAM (CD326) and Her2/neu positive tumor cells and a clinically significant reduction of the effusion volume were found following application of MB311.…”