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Effects of video-assisted thoracoscopic surgery and conventional open thoracotomy on level of circulating tumor cells of patients with non-small-cell lung cancer during perioperative period

HUANG Hong-bo1, XIE Ting-hong2, SU Ming-hang2, SONG Yuan-mao2, GE Ming-jian1   

  1. 1.Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016,China; 2.Department of Surgery, Zunyi City People's Hospital, Zunyi 563100, China
  • Online:2014-08-28 Published:2014-09-02
  • Supported by:

    Medical Research Project of Chongqing Municipal Health Bureau,12-2; Scientific Research Project of Zunyi Municipal Science and Technology Bureau, Guizhou Province, 2011-42

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Abstract:

Objective To observe the circulating tumor cells (CTCs) of patients with non-small-cell lung carcinoma (NSCLC) during the perioperative period and to compare the effects of video-assisted thoracoscopic surgery (VATS) and conventional open thoracotomy on the dynamic changes of CTCs. Methods Sixty-three patients with NSCLC were randomly divided into the VATS group (n=33) and conventional open thoracotomy group (n=30). Peripheral blood samples of 8 mL were collected during surgery, 3 d before and after surgery, respectively. CTCs were sorted and enriched by the CD326 (EpCAM) immunomagnetic cell enrichment and labeled by the fluorescent-labeled monoclonal antibodies CK-PE and CD45-FITC. The quantitative measurement of CTCs was conducted by the multi-parameter flow cytometry. Meanwhile, 10 patients with benign lung disease and 10 healthy volunteers were selected as controls. Results Thirty-seven of 63 (58.73%) patients with NSCLC were CTCs positive. The controls were all CTCs negative. For patients with NSCLC, the intra-operative CTC level was significantly higher than the preoperative CTC level and the postoperative CTC level was higher than the intra-operative CTC level. The differences were statistically significant (P<0.05 or P<0.01). The differences of preoperative and intra-operative CTC level of the VATS group and conventional open thoracotomy group were not statistically significant (P>0.05), but the postoperative CTC level of the VATS group was significantly lower than that of the conventional open thoracotomy group and  the increase of CTC level from preoperation to postoperation of the VATS group was significantly lower than that of the conventional open thoracotomy group. The differences were statistically significant (P<0.05). Conclusion Compared to the conventional open thoracotomy, the increase of postoperative CTC level of VATS is significantly lower, which may be helpful for reducing the survival of surgically disseminated tumor cells in the early postoperative period and improving the long-term survival of patients.

Key words: non-small-cell lung carcinoma, immunomagnetic beads, flow cytometry, circulating tumor cells, video-assisted thoracoscopic surgery