The combination of computed tomography features and circulating tumor cells increases the surgical prediction of visceral pleural invasion in clinical T1N0M0 lung adenocarcinoma

Shi, Jun; Li, Fēi; Yang, Fujun; Dong, Zhengwei; Jiang, Yan; Nachira, Dania; Chałubińska-Fendler, Justyna; Sio, Terence T.; Kawaguchi, Yo; Takizawa, Hiromitsu; Song, Xiao; Hu, Yang; Duan, Liang

doi:10.21037/tlcr-21-896

Cited by 14 publications

(14 citation statements)

References 58 publications

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“…It follows the "seeds and soil" hypothesis, which states that successful metastasis depends not only on tumor-related factors ("seeds"), but also on the target organ microenvironment ("soil") [11]. The CT imaging features [12,13], histological subtypes [14], genomic alterations [15,16], clinical stage, T stage, and N stage [14] are primary tumor-related factors, and they can re ect invasiveness. They may affect the distribution of BMs.…”

Section: Introductionmentioning

confidence: 99%

Analysis of factors influencing the distribution of brain metastases from lung cancer: A retrospective study

Hu,

Lei,

Xin

et al. 2024

Preprint

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BACKGROUND The distribution of brain metastases (BMs) in patients with lung cancer may be related to primary tumor and cerebral small vascular diseases (CSVDs), but it is not clear which one or more factors affect the distribution. PURPOSE To investigate the effects of primary tumor-related factors and CSVDs on the distribution of BMs (the number of BMs in each brain region) in patients with lung cancer. METHODS A total of 5,788 lesions in 823 patients with BMs from lung cancer were enrolled. The numbers of BMs and CSVDs in 15 brain regions were determined. CSVDs included recent small subcortical infarcts (RSSIs), perivascular spaces, and lacunes of presumed vascular origin (LPVOs). We collected the number of CSVDs, primary tumor-related factors (including clinical and imaging features) and other potential influencing factors (including the patient's general condition and treatment). We used univariate and multivariate linear regression models to analyze the influence of the above factors on the number of BMs in 15 brain regions. In addition, we performed subgroup analyses of all patients with adenocarcinoma (AD), male patients with AD, female patients with AD, and patients with small cell lung cancer (SCLC). RESULTS Univariate linear regression analyses showed that bone metastasis, adrenal metastasis, RSSIs, and LPVOs greatly affected the number of BMs in over half of the examined brain regions. Multivariate linear regression analyses showed LPVOs independently affected the number of BMs in nine brain regions. In the subgroup analyses of all AD, male AD, female AD, and SCLC, LPVOs independently affected the number of BMs in eight, seven, and nine brain regions, respectively. CONCLUSIONS The distribution of BMs is mainly affected by LPVOs, while primary tumor-related factors have less influence on the distribution of BMs.

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Section: Introductionmentioning

confidence: 99%

Analysis of factors influencing the distribution of brain metastases from lung cancer: A retrospective study

Hu,

Lei,

Xin

et al. 2024

Preprint

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“…Some researchers have proposed combinations of features of the tumor-pleura relationship on computed tomography (CT). These features include direct pleural contact of the tumor, pleural retraction, and pleural tags [ 7 - 10 ]. However, a study by Kim et al [ 7 ], which examined CT-defined VPI and its correlation with disease-free survival in a retrospective review of 695 patients, revealed that approximately one-half of the findings were false positives.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple separate studies have proposed alternative methods for the preoperative assessment of VPI, such as the measurement of circulating tumor cells from serum and pre-resectional pleural lavage tumor cytology. However, these approaches require further research for validation [ 8 , 11 ]. The maximum standardized uptake value (SUVmax) and serum carcinoembryonic antigen (CEA) level have also been identified as significant risk factors for VPI, but no definite cutoff values have been established for diagnosis [ 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Pleural Carcinoembryonic Antigen and Maximum Standardized Uptake Value as Predictive Indicators of Visceral Pleural Invasion in Clinical T1N0M0 Lung Adenocarcinoma

Na,

Moon,

Kim

et al. 2024

J Chest Surg

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Background Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14–7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90–14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

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“…Since CTCs are live cells, they can be used in drug screens and functional assays. More importantly, they may predict relapse after primary treatment ( 3 ) even in early stage NSCLC ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Gene expression profiling of circulating tumor cells captured by MicroCavity Array is superior to enumeration in demonstrating therapy response in patients with newly diagnosed advanced and locally advanced non-small cell lung cancer

Cohen¹,

Jayachandran²,

Gao³

et al. 2023

Transl Lung Cancer Res

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Background Circulating tumor cells (CTCs) are a promising non-invasive tool for monitoring therapy response. The only Food and Drug Administration (FDA)-approved test is limited to enumeration of epithelial CTC without further characterization and is not approved for the management of non-small cell lung cancer (NSCLC). Here we use a MicroCavity Array (MCA) system to capture CTC agnostic of epithelial markers for further molecular testing in NSCLC. Methods CTCs were enumerated by fluorescent microscopy as longitudinal sampling throughout disease management from 213 NSCLC patients. CTC-enriched samples from a subset of 127 patients were interrogated for gene expression by reverse transcription polymerase chain reaction (RT-PCR) using a customized pre-selected panel of 20 genes. Results At least 1 CTC was detected by enumeration in 53.8% of samples. Most patients had fewer than 5 CTCs (91%) and the highest observed count was 35 CTCs. Enumeration of single CTCs was not prognostic, although detection of CTC clusters at any time point was associated with increased risk of progression [hazard ratio (HR) 3.00, 95% confidence interval (CI): 1.1–8.2, P=0.0318]. In contrast, 124 (97.6%) patients with samples interrogated for gene expression had at least 1 gene detectable in at least 1 sample, and 101 (79.5%) had at least one elevated epithelial gene in at least one timepoint. High expression of BCL2, CD274 [programmed death-ligand 1 (PD-L1)], CDH1, EPCAM, FGFR1, FN1, KRT18, MET and MUC1 were associated with poor prognosis. Patients with CTCs positive for at least 3 epithelial genes at baseline all progressed within 10 months (HR 8.2, P<0.001, 95% CI: 3.2–21.1). BCL2, CD274 (PD-L1), EPCAM and MUC1 remained significant independent prognostic factors in multivariate, time-dependent analyses of progression and death. Conclusions The selective profile of CTC genes and identification of CTC clusters better correlated with prognosis than enumeration of enriched CTC in NSCLC patients in this study.

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The combination of computed tomography features and circulating tumor cells increases the surgical prediction of visceral pleural invasion in clinical T1N0M0 lung adenocarcinoma

Cited by 14 publications

References 58 publications

Analysis of factors influencing the distribution of brain metastases from lung cancer: A retrospective study

Analysis of factors influencing the distribution of brain metastases from lung cancer: A retrospective study

Pleural Carcinoembryonic Antigen and Maximum Standardized Uptake Value as Predictive Indicators of Visceral Pleural Invasion in Clinical T1N0M0 Lung Adenocarcinoma

Gene expression profiling of circulating tumor cells captured by MicroCavity Array is superior to enumeration in demonstrating therapy response in patients with newly diagnosed advanced and locally advanced non-small cell lung cancer

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