Noriyuki Matsutani1, Noriyoshi Sawabata2, Masafumi Yamaguchi3, Tetsukan Woo4, Yujin Kudo5, Akikazu Kawase6, Satoshi Shiono7, Hisae Iinuma1, Shigeki Morita8, Masafumi Kawamura1. 1. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. 2. Department of Thoracic Surgery, Hoshigaoka Medical Center, Osaka, Japan. 3. Department of General Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. 4. Department of Thoracic Surgery, Saiseikai Yokohama City South Hospital, Kanagawa, Japan. 5. Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan. 6. First Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan. 7. Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. 8. Department of Diagnostic Pathology, University Hospital, Teikyo University School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND: Cancer relapse is caused by residual isolated tumor cells (ITCs) remaining in the body after surgery. It is speculated that surgical manipulation may cause circulating tumor cells (CTCs) which are the origin of ITCs in the body. The occurrence of CTCs in surgical patients with non-small cell lung cancer (NSCLC) has been shown in retrospective observation, but not prospectively, thus we conducted a multicenter prospective study regarding the occurrence of CTCs by surgical manipulation. METHODS: Patients with T1b-2N0M0 lung cancer were studied. Blood samples were collected from the peripheral artery in the operating room at both pre- and post-lobectomy to extract CTCs by a size selection method. The CTCs detection rate, pathological findings, and background of each patient were studied. RESULTS: The histological diagnosis of 29 patients were adenocarcinoma in 24 patients, squamous cell carcinoma in 3 patients, and other types in 2 patients. The number of pre-CTCs positive patients was 13 and the number of post CTCs positive patients was 17. Among the 16 patients who were pre-CTCs negative, 4 patients showed post CTCs positive, while all pre-CTCs positive patients remained post-CTCs positive. CONCLUSIONS: The likelihood of CTC dislodgement by surgical manipulation is indicated based on the result that CTCs were detected after lung cancer surgery, where there were no cases of pre-CTCs positive and post CTCs negative.
BACKGROUND:Cancer relapse is caused by residual isolated tumor cells (ITCs) remaining in the body after surgery. It is speculated that surgical manipulation may cause circulating tumor cells (CTCs) which are the origin of ITCs in the body. The occurrence of CTCs in surgical patients with non-small cell lung cancer (NSCLC) has been shown in retrospective observation, but not prospectively, thus we conducted a multicenter prospective study regarding the occurrence of CTCs by surgical manipulation. METHODS:Patients with T1b-2N0M0 lung cancer were studied. Blood samples were collected from the peripheral artery in the operating room at both pre- and post-lobectomy to extract CTCs by a size selection method. The CTCs detection rate, pathological findings, and background of each patient were studied. RESULTS: The histological diagnosis of 29 patients were adenocarcinoma in 24 patients, squamous cell carcinoma in 3 patients, and other types in 2 patients. The number of pre-CTCs positive patients was 13 and the number of post CTCs positive patients was 17. Among the 16 patients who were pre-CTCs negative, 4 patients showed post CTCs positive, while all pre-CTCs positive patients remained post-CTCs positive. CONCLUSIONS: The likelihood of CTC dislodgement by surgical manipulation is indicated based on the result that CTCs were detected after lung cancer surgery, where there were no cases of pre-CTCs positive and post CTCs negative.
Authors: T Wiggers; J Jeekel; J W Arends; A P Brinkhorst; H M Kluck; C I Luyk; J D Munting; J A Povel; A P Rutten; A Volovics Journal: Br J Surg Date: 1988-05 Impact factor: 6.939