Clinical Study On Ctcs' Value In Evaluating Chemotherapeutic Effect Of Advanced Nsclc And Prognosis

Objective: To explore the circulating tumor cells' (CTCs) value in evaluating chemotherapeutic effect of advanced non-small cell lung cancer (NSCLC) and prognosis. Methods: Eighty-six advanced NSCLC patients were divided into high expression group and low expression group. Using the median of CTCs expression values of all patients as the demarcation point, those higher than the median were deemed as high expression, and those lower than the median were deemed as low expression. The expression level of CTCs was determined by flow cytometry before and after 4 cycles of chemotherapy. The CTCs expression level was compared with chemotherapeutic effect, progression free survival (PFS) and overall survival (OS). Results: In the aspect of therapeutic effect, the low CTCs expression group had a response rate (RR) of 47.9% (23/48) and a disease control rate (DCR) of 72.9% (35/48). The high CTCs expression group had a RR of 31.5% (12/38) and a DCR of 57.8% (22/38). Patients with a low CTCs level before chemotherapy had better RR and clinical remission rate than those with a high CTCs level. Compared with patients without dramatic decline in the CTCs level after chemotherapy, those with dramatic decline in the CTCs level after chemotherapy had better chemotherapeutic effect. The difference between two groups was statistically significant (P < 0.05). In the aspect of prognosis, the median OS of low CTCs expression group and high CTCs expression group was 21.5 months (95% CI: 17.1-26.9 months) and 16.3 months (95% CI: 11.8-20.5 months), respectively. The median PFS was 10.5 months (95% CI: 6.9-13.8 months) and 5.1 months (95% CI: 3.3-7.2 months), respectively. The comparison of the two groups showed P < 0.05, indicating statistical significance. Patients with low CTCs expression had longer OS and PFS compared with those with high expression. Conclusion: The CTCs level can be used as an index predicting the chemotherapeutic effect of advanced NSCLC patients. The chemotherapeutic effect was negatively correlated with the CTCs level. Dynamic change of the CTCs level can be an effective index to evaluate chemotherapeutic effect. Meanwhile, the CTCs expression level was negatively correlated with the prognosis of advanced NSCLC patients. The change of CTCs expression levels can be used as an index evaluating the prognosis of advanced NSCLC patients.