肺腺癌における赤血球分布幅と上皮-間葉転移表現型を有する循環腫瘍細胞の臨床的意義

Clinical Significance of Red Cell Distribution Width and Circulating Tumor Cells with an Epithelial-Mesenchymal Transition Phenotype in Lung Adenocarcinoma.

• Huajian Peng
• Xiang Tan
• Yongyong Wang
• Lei Dai
• Guanbiao Liang
• Jianji Guo
• Mingwu Chen

抄録

目的:

肺腺癌（LUAD）における赤血球分布幅（RDW）と上皮間葉転換表現型（M-CTC）を有する循環腫瘍細胞の予後予測値を決定すること。

Objective: To determine the prognostic value of red cell distribution width (RDW) and circulating tumor cells with epithelial-mesenchymal transition phenotype (M-CTC) in lung adenocarcinoma (LUAD).

患者と方法:

LUAD患者60名の臨床データと検査データを収集した。CanPatrol CTC濃縮法を用いて末梢血からCTCを分離した。RDWおよび好中球リンパ球比（NLR）の指標は、検査室基準に基づいて算出した。

Patients and Methods: Clinical and laboratory data of 60 patients with LUAD were collected. CTCs were isolated from their peripheral blood using the CanPatrol CTC enrichment method. The indicators of RDW and neutrophil lymphocyte ratio (NLR) were calculated based on the laboratory standards.

結果:

LUAD患者60例が登録され，そのうち19例（31.7％）が高RDW（＞0.14），32例（53.3％）がM-CTC陽性であった。RDWと臨床的特徴との間には有意な相関は認められなかった。M-CTCは、腫瘍の大きさや分化度、年齢、性別、腫瘍病期、組織型と有意な相関はなかったが、リンパ系転移（P＝0.044）、高NLR（＞2.26、P＝0.023）、高RDW（＞0.14、P＝0.036）と有意な相関があった。さらに、M-CTC LUAD患者は、M-CTC患者に比べて無再発生存期間（RFS；Log rank P =0.001、HR =2.749、95% CI =1.489-5.078）および全生存期間（OS；Log rank P =0.022、HR =2.283、95% CI =1.128-4.622）が有意に不良であった。同様に、RDWが高いと、RFS（Log rank P = 0.008、HR = 2.331、95% CI = 1.248-4.353）およびOS（Log rank P = 0.004、HR = 0.004、95% CI = 1.398-5.525）の悪化とも相関した。

Results: A total of 60 LUAD patients were enrolled, of which 19 (31.7%) had high RDW (>0.14) and 32 (53.3%) were positive for M-CTCs. There was no significant correlation between RDW and the clinical characteristics. M-CTC was not significantly associated with tumor size and differentiation, age, gender, tumor stage, and histological type but correlated significantly with lymphatic metastasis (P = 0.044), high NLR (>2.26, P = 0.023), and high RDW (>0.14, P = 0.036). Furthermore, the M-CTC LUAD patients had a significantly poor recurrence-free survival (RFS; Log rank P =0.001, HR = 2.749, 95% CI = 1.489-5.078) and overall survival (OS; Log rank P =0.022, HR = 2.283, 95% CI = 1.128-4.622) compared to the M-CTC patients. Similarly, high RDW also correlated with worse RFS (Log rank P = 0.008, HR = 2.331, 95% CI = 1.248-4.353) and OS (Log rank P = 0.004, HR = 0.004, 95% CI = 1.398-5.525).

結論:

M-CTCはRDWとNLRに有意に関連し、LUADでは独立した予後因子である。

Conclusion: M-CTC is significantly related to RDW and NLR, and an independent prognostic factor in LUAD.

© 2020 Peng et al.