Introduction The type of lung cancer surgery impacts on tumour manipulation during surgery and may drive dissemination of cancer cells into the vasculature, thus facilitating metastatic spread. The aim of this study was to investigate the impact of surgically induced trauma using peripheral blood from preoperative and postoperative patients with non-small cell lung cancer (NSCLC) undergoing thoracotomy or video-assisted thoracoscopic surgery (VATS) resection. Methods Imaging flow cytometry was used to measure circulating cancer-associated cells (CCs). Circulating cell-free DNA (ccfDNA) isolation was performed using Promega dsDNA HS Assay Kit. DNA integrity measurements were calculated by the ALU247 to ALU115 ratio and cytokine levels measured using the Luminex screening assay. Results CCs were increased in postoperative blood samples in 54 patients with NSCLC. Patients who underwent thoracotomy instead of VATS had higher numbers of EpCAM (p=0.004) and PanCK-labelled (p=0.03) CCs postoperatively. ccfDNA and DNA integrity index were also significantly increased in postoperative samples (p=0.0009 and p=0.04), with concomitant increase in interleukin 6 and interleukin 10 levels in the same cohorts (p=0.0004 and p=0.034, respectively). Conclusions In this study we have shown the potential clinical utility of several biomarkers from liquid biopsies to guide perioperative management, as well as provide a snapshot of the type of surgical resection in terms of circulating tumour cell release. Obtaining reliable readouts from blood can provide crucial information for disease progression, as well as being of prognostic value monitoring patients’ response to treatment. Data are available upon reasonable request.

中文翻译：

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肺癌患者的循环肿瘤细胞和循环游离 DNA：开胸术与电视胸腔镜手术的比较

简介 肺癌手术的类型会影响手术期间的肿瘤操作，并可能促使癌细胞扩散到脉管系统中，从而促进转移性扩散。本研究的目的是研究使用术前和术后非小细胞肺癌 (NSCLC) 患者接受开胸或电视胸腔镜手术 (VATS) 切除术的外周血手术诱发创伤的影响。方法 成像流式细胞仪用于测量循环癌相关细胞（CCs）。使用 Promega dsDNA HS Assay Kit 进行循环游离​​ DNA (ccfDNA) 分离。DNA 完整性测量值通过 ALU247 与 ALU115 的比率计算，并使用 Luminex 筛选测定法测量细胞因子水平。结果 54 例 NSCLC 患者术后血样中 CCs 增加。接受开胸术而不是 VATS 的患者术后 EpCAM (p=0.004) 和 PanCK 标记 (p=0.03) CCs 的数量较高。术后样本中的 ccfDNA 和 DNA 完整性指数也显着增加（p=0.0009 和 p=0.04），同时同一队列中的白细胞介素 6 和白细胞介素 10 水平也随之增加（分别为 p=0.0004 和 p=0.034）。结论 在本研究中，我们展示了液体活检中的几种生物标志物在指导围手术期管理方面的潜在临床效用，并在循环肿瘤细胞释放方面提供了手术切除类型的快照。从血液中获得可靠的读数可以为疾病进展提供重要信息，以及监测患者对治疗的反应的预后价值。可根据合理要求提供数据。