Lung adenocarcinoma (LUAD) is one of the leading causes of cancer-related deaths worldwide, with a 5-year survival rate of approximately 19%. With the advent of screening and diagnostic techniques such as low-dose spiral CT and liquid biopsy, the detection rate of early stage LUAD is increasing. Even in stage I LUAD, the cumulative 5-year recurrence rate after radical surgical resection is 17.9%. This may be related to the presence of microscopic residual disease (MRD), a potential source of recurrence and metastasis. Circulating tumour cells (CTCs) are key biomarkers in liquid biopsies, but the ability of dynamic CTC detection to monitor MRD and warn of recurrence in patients with early LUAD has not been validated. Here, we conducted a prospective study using the telomerase reverse transcriptase-based CTC detection method (TBCD) to evaluate perioperative and follow-up CTC levels for dynamic monitoring to evaluate its clinical efficacy in predicting postoperative recurrence in early-stage LUAD. By longitudinal dynamic monitoring of CTC, we accurately predicted recurrence within 2 years after surgery, with an AUC of 0.9786, demonstrating the clinical values of CTC in predicting recurrence. The median lead time from positive detection of CTC to radiological recurrence was 183 days, with the earliest CT recurrence predicted 354 days in advance. Taken together, our study demonstrates that longitudinal monitoring of CTC is effective in early warning of LUAD recurrence and provides valuable information on early detection and intervention strategies for the management of LUAD.

中文翻译：

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使用循环肿瘤细胞动态监测微小残留病灶，以预测早期肺腺癌的复发


肺腺癌 （LUAD） 是全球癌症相关死亡的主要原因之一，5 年生存率约为 19%。随着低剂量螺旋 CT 和液体活检等筛查和诊断技术的出现，早期 LUAD 的检出率正在提高。即使在 I 期 LUAD 中，根治性手术切除后的 5 年累积复发率也为 17.9%。这可能与显微镜下残留病灶 （MRD） 的存在有关，MRD 是复发和转移的潜在来源。循环肿瘤细胞 （CTC） 是液体活检中的关键生物标志物，但动态 CTC 检测监测 MRD 和警告早期 LUAD 患者复发的能力尚未得到验证。在这里，我们使用基于端粒酶逆转录酶的 CTC 检测方法 （TBCD） 进行了一项前瞻性研究，以评估围手术期和随访 CTC 水平以进行动态监测，以评估其在预测早期 LUAD 术后复发方面的临床疗效。通过对 CTC 的纵向动态监测，我们准确预测了术后 2 年内的复发，AUC 为 0.9786，证明了 CTC 预测复发的临床价值。从 CTC 阳性检测到放射学复发的中位提前期为 183 天，最早的 CT 复发预测提前 354 天。综上所述，我们的研究表明，CTC 的纵向监测可有效预防 LUAD 复发的早期预警，并为 LUAD 管理的早期检测和干预策略提供有价值的信息。