Detection of circulating tumor cells in patients with non-small cell lung cancer undergoing lobectomy by video-assisted thoracic surgery: A potentialhazard for intraoperative hematogenous tumor cell dissemination
J. Yamashita et al., Detection of circulating tumor cells in patients with non-small cell lung cancer undergoing lobectomy by video-assisted thoracic surgery: A potentialhazard for intraoperative hematogenous tumor cell dissemination, J THOR SURG, 119(5), 2000, pp. 899-905
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective: We prospectively tested whether circulating tumor cells can be f
ound in the preoperative, intraoperative, and postoperative peripheral bloo
d of patients with resectable non-small cell lung cancer who undergo video-
assisted lobectomy.
Methods: We assayed for carcinoembryonic antigen messenger RNA (mRNA) by re
verse transcriptase-polymerase chain reaction in the peripheral blood taken
before, during, just after the completion of the lobectomy and then 2 to 3
weeks, and again 5 to 6 weeks, after the operation in 29 patients with pat
hologic stage I non-small cell lung cancer who underwent video-assisted lob
ectomy. We also analyzed the prognostic value of carcinoembryonic antigen m
RNA expression pattern in an additional 57 patients with stage I non-small
cell lung cancel; whose blood samples were previously assayed for carcinoem
bryonic antigen mRNA.
Results: Of the 29 patients, the preoperative blood samples from 18 patient
s were negative for carcinoembryonic antigen mRNA. Of these 18 patients, 16
(89%) had positive test results during operation, although the remaining 2
patients (11%) consistently showed negative test results. The occurrence o
f this change from negative to positive tests results for carcinoembryonic
antigen mRNA during video-assisted lobectomy was significantly higher than
in patients who underwent open lobectomy in a previous study (18 of 35 pati
ents; 51%; P < .001). In the 57 patients with stage I cancer whose blood sa
mples were previously assayed for carcinoembryonic antigen mRNA, patients w
ith persistently positive test results for carcinoembryonic antigen mRNA be
fore and during operation had a significantly shorter survival when compare
d with those patients whose test results were persistently positive.
Conclusions: Video-assisted lobectomy, as compared with open lobectomy, for
non-small cell lung cancer may increase the risk of seeding tumor cells in
to the circulation during operation.