title: Association of circulating tumour cells with early relapse and 18F-fluorodeoxyglucose positron emission tomography uptake in resected non-small-cell lung cancers.
abstract: OBJECTIVE
  More than 20% of lung cancer patients develop a recurrence, even after curative resection. We hypothesized that relapse may arise from the dissemination of circulating tumour cells (CTCs). This study evaluates the significance of CTC detection as regards the recurrence of non-small-cell lung cancer (NSCLC) in surgically resected patients. Secondly, we investigated the association between CTCs and the uptake of 18 F-fluorodeoxyglucose (FDG) by the primary tumour on a positron emission tomographic (PET) scan.
  
  
  METHODS
  In this single-centre prospective study, blood samples for analysis of CTCs were obtained from 102 patients with Stage I-IIIA NSCLC both before (CTC1) and 1 month after (CTC2) radical resection. CTCs were isolated using immunomagnetic techniques. The presence of CTCs was correlated with the maximum standardized uptake value (SUVmax) measured on preoperative FDG PET/computed tomographic scans. Recurrence free survival (RFS) analysis was performed.
  
  
  RESULTS
  CTCs were detected in 39.2% of patients before and in 27.5% 1 month after the operation. The presence of CTCs after the operation was significantly correlated with SUVmax on PET scans, pathological stage and surgical approach. Only SUVmax was an independent predictor for the presence of CTC2 on multivariate analysis. Postoperative CTCs were significantly correlated with a shorter RFS ( P  = 0.005). In multivariate analysis, the presence of CTC2 was associated with RFS, independent of disease staging.
  
  
  CONCLUSIONS
  Detection of CTCs 1 month after radical resection might be a useful marker to predict early recurrence in Stage I-III NSCLC. The SUVmax value of the primary tumour on preoperative PET scans was associated with the presence of CTC 1 month after the operation.
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Clara I
authors.initials: CI
authors.lastname: Bayarri-Lara
authors.affiliation: Liquid Biopsy and Metastasis Research Group, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government-PTS Granada, Granada, Spain.|Laboratory of Genetic Identification, Legal Medicine and Toxicology Department, Faculty of Medicine, University of Granada, Granada, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: de Miguel Pérez
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cueto Ladrón de Guevara
authors.affiliation: Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rodriguez Fernández
authors.affiliation: Liquid Biopsy and Metastasis Research Group, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government-PTS Granada, Granada, Spain.|Division of Integral Oncology, University Hospital of Granada, Granada, Spain.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Puche
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Abel
authors.initials: A
authors.lastname: Sánchez-Palencia Ramos
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Ruiz Zafra
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Giraldo Ospina
authors.affiliation: Division of Preventive Medicine and Public Health, University of Jaén, Jaén, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado-Rodríguez
authors.affiliation: Division for Methodological Assessment, Alejandro Otero Biomedical Research Fundation (FIBAO), Granada, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Expósito Ruiz
authors.affiliation: Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Moyano Rodriguez
authors.affiliation: Liquid Biopsy and Metastasis Research Group, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government-PTS Granada, Granada, Spain.|Laboratory of Genetic Identification, Legal Medicine and Toxicology Department, Faculty of Medicine, University of Granada, Granada, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Lorente
authors.affiliation: Liquid Biopsy and Metastasis Research Group, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government-PTS Granada, Granada, Spain.|Division of Preventive Medicine and Public Health, University of Jaén, Jaén, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Serrano
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000378:metabolism; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism / Q000473:pathology*; D011013:Pneumonectomy; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013997:Time Factors
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Circulating tumour cells; FDG PET/CT; Non-small-cell lung cancer; Recurrence