【摘要】 目的 探讨动态监测循环肿瘤细胞(CTC)在预测寡转移非小细胞肺癌(NSCLC)患者全身治疗及局部放射治疗预后的潜在应用价值。方法 2019年1月至2020年12月确诊为无EGFR、ALK和ROS1突变的寡转移NSCLC患者52例，经全身治疗后，40例影像学评估为部分缓解或疾病稳定的患者纳入研究。所有患者接受帕博利珠单抗维持治疗，其中20例(50.0%)还接受所有转移病灶的放射治疗。收集所有患者维持治疗前、治疗后12个月的CTC及其生存资料。据患者维持治疗前至治疗后12个月CTC值的变化，将40例患者分为CTC下降组、稳定组和上升组，进行生存分析。结果 Kaplan-Meier生存分析显示，CTC不同变化组中位无进展生存期(PFS)分别为30.86、23.80、17.49个月(χ~2=8.616,P=0.013)。CTC不同变化组中位总生存期分别为32.23、26.64、19.66个月(χ~2=10.809,P=0.004)。在单因素及多因素Cox回归中，对转移灶进行放疗(HR=1.863,95%CI:1.263,2.749,P=0.002)、不同CTC变化(HR=2.562,95%CI:1.452,4.522,P=0.001)为PFS的独立预后因素。结论 动态监测CTC可以预测无EGFR、ALK、ROS1突变的寡转移NSCLC患者联合治疗的预后，具有一定的临床应用价值。更多还原

【Abstract】 Objective To investigate the potential application value of dynamic monitoring of circulating tumor cell(CTC) in predicting the prognosis of systemic treatment and local radiotherapy in patients with oligometastatic non-small cell lung cancer(NSCLC).Methods From January 2019 to December 2020, 52 patients diagnosed with oligometastatic NSCLC without EGFR, ALK, and ROS1 mutations were included in the study.After systemic treatment, 40 patients with partial response or stable disease evaluated by imaging examination were included in the study.All patients received Pembrolizumab maintenance treatment, of which 20 patients(50.0%) also received radiotherapy for all metastasis.Collect CTC values of all patients before and 12 months after maintenance treatment and survival data.According to the changes in CTC values between before and 12 months after maintenance treatment, 40 patients were divided into a decreasing group(with a decrease in CTC count), a stable group(with no change in CTC count), and an increasing group(with an increase in CTC count) for survival analysis.Results Kaplan-Meier survival analysis showed that the median progress free survival(PFS) of different CTC change groups was 30.86, 23.80, and 17.49 months(χ~2=8.616, P=0.013).The median overall survival(OS) of different groups of CTC change groups were 32.23, 26.64, and 19.66 months(χ~2=10.809, P=0.004).The result of univariate and multivariate Cox regression revealed that radiotherapy for all metastatic lesions(HR=1.863,95%CI: 1.263,2.749, P=0.002) and different CTC changes(HR=2.562,95%CI: 1.452,4.522, P=0.001) were independent prognostic factors for PFS.Conclusion Dynamic monitoring of CTC can predict the prognosis of oligometastatic NSCLC patients without EGFR, ALK, or ROS1 mutations in combination therapy, and has certain clinical value.更多还原