• Lijuan Ren, Xiaoming Zhong, Wei Liu, Di Xu, Yiyan Lei, Jianwen Zhou, Wenting Jiang, Qiong He, Yu Sun, and Zunfu Ke.
• Molecular Diagnosis and Gene Testing Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
• Ann. Surg. 2023 Feb 1; 277 (2): e439e448e439-e448.

ObjectiveTo investigate the effectiveness of a CTC-based classifier in stratifying stage IB LUAD.Summary Of Background DataStage IB LUADs have an approximately 70% 5-year survival rate. The clinical application of ACT is controversial due to inconsistent results in a series of trials and few useful guide biomarkers. Thus, there is a pressing need for robust biomarkers to stratify stage IB patients to define which group would most likely benefit from ACT. Methods: Two hundred twelve stage IB LUAD patients were enrolled and were divided into 3 independent cohorts. The aptamer-modified NanoVelcro system was used to enrich the CTCs.ResultsA cutoff of <4 or >4 CTCs as the optimal prognostic threshold for stage IB LUAD was generated to stratify the patients in a 70-patient cohort into low-risk and high-risk groups. Patients with ≥ 4 CTCs in the training cohort had shorter progression-free survival ( P < 0.0001) and overall survival ( P < 0.0001) than patients with <4 CTCs. CTC number remained the strongest predictor of progression-free survival and overall survival even in a multivariate analysis including other clinicopathological parameters. Furthermore, a nomogram based on the CTC count was developed to predict the 3-year and 5-year survival in the training cohort and performed well in the other 2 validation cohorts (C-index: 0.862, 0.853, and 0.877).ConclusionThe presence of >4 CTCs can define a high-risk subgroup, providing a new strategy to make optimal clinical decisions for stage IB LUAD.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

7 keywords...

hide…