BACKGROUND: Surgical treatment of early-stage non-small cell lung cancer (NSCLC) yields highest expectations for recovery. However, the frequency of further disease progression remains high since micro-metastatic disease may be undetected by conventional diagnostic methods. We test the presence and prognostic impact of circulating tumor cells (CTCs) in peripheral blood (PB), tumor-draining pulmonary blood (TDB) and bone marrow (BM) samples from NSCLC patients. METHODS: The presence of circulating/disseminated tumor cells (CTCs/DTCs) was detected by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) analysis in PB, TDB and BM samples before surgery in 119 stage IA-IIIA NSCLC patients (Clinical Trial NS10285). RESULTS: NSCLC patients with the presence of carcinoembryonic antigen (CEA) mRNA-positive CTCs/DTCs in TDB and BM had significantly shorter cancer-specific survival (CSS) (P<0.013, resp. P<0.038). Patients with the presence of epithelial cellular adhesion molecule (EpCAM) mRNA-positive CTCs in TDB samples had significantly shorter CSS and disease-free survival (DFS) (P<0.031, resp. P<0.045). A multivariate analysis identified the presence of CEA mRNA-positive CTCs in the PB as an independent negative prognostic factor for DFS (P<0.005). No significant correlation of CTCs/DTCs presence and other prognostic factors was found. CONCLUSIONS: In NSCLC patients undergoing radical surgery, the presence of CEA and EpCAM mRNA-positive CTCs/DTCs is associated with poorer survival.

Cancer Research Czech Republic Olomouc Czech Republic

Department of Surgery Faculty of Medicine and Dentistry Palacky University and University Hospital in Olomouc Olomouc Czech Republic

Department of Surgery Tomas Bata Regional Hospital Zlin Czech Republic

Department of Thoracic Surgery Clinic Floridsdorf Vienna Austria

Faculty of Healthcare Alexander Dubcek University of Trencin Trencin Slovakia

Institute of Molecular and Clinical Pathology and Medical Genetics Faculty of Medicine University of Ostrava Ostrava Czech Republic

Laboratory of Experimental Medicine Institute of Molecular and Translational Medicine Faculty of Medicine and Dentistry Czech Advanced Technology and Research Institute Palacky University in Olomouc Olomouc Czech Republic

Laboratory of Experimental Medicine University Hospital in Olomouc Olomouc Czech Republic

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