Thorac Cardiovasc Surg 2016; 64(06): 515-519
DOI: 10.1055/s-0035-1552925
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

The Effects of Different Surgical Approaches on the Perioperative Level of Circulating Tumor Cells in Patients with Non-Small Cell Lung Cancer

Hong Bo Huang
1  Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo, Zhejiang Province, China
Ming Jian Ge
2  Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing, China
› Author Affiliations
Further Information

Publication History

03 January 2015

29 March 2015

Publication Date:
01 June 2015 (online)


Background To observe and compare the effects of video-assisted thoracoscopic surgery (VATS) and conventional thoracotomy on the levels of circulating tumor cells (CTCs) in patients with non-small cell lung carcinoma (NSCLC).

Methods Seventy-nine patients with a diagnosis of NSCLC were enrolled in the study. Forty-three were treated with VATS and 36 were treated with conventional thoracotomy. Blood samples were collected 3 days prior to surgery (d-3), during surgery (d0), and 3 days after surgery (d3). After epithelial cell adhesion molecule (EpCAM)-labeled immunomagnetic cell enrichment, anti-CK-PE and anti-CD45-FITC fluorescent-labeled monoclonal antibodies were added to sort CTCs. Quantification of CTCs was performed using multiparameter flow cytometry.

Results The number of CTCs on d0 was significantly higher than on d-3 (5.730 ± 4.266 vs. 4.142  ± 3.971, p = 0.033) in both groups. There was no significant difference in the change of CTCs from before surgery to during surgery in the VATS and conventional thoracotomy (open) groups (1.363  ± 2.924 vs. 1.500  ± 2.315, p = 0.329). However, the increase in number of CTCs from before surgery to after surgery was significantly lower in the VATS group than in the conventional thoracotomy (open) group (2.181  ± 2.962 vs. 9.666  ± 15.641, p = 0.015). Thirty of the 79 patients tested positive for CTCs before surgery (37.97%). All benign lung disease patients and volunteers tested negative for CTCs.

Conclusion A smaller increase in CTCs was seen in patients treated with VATS lobectomy than in patients treated with conventional thoracotomy. This reduction in number of postoperative CTCs may improve long-term survival.