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Xie J, Hu B, Gong Y, He S, Lin J, Huang Q, Cheng J. A comparative study on ctDNA and tumor DNA mutations in lung cancer and benign cases with a high number of CTCs and CTECs. J Transl Med 2023; 21:873. [PMID: 38041139 PMCID: PMC10691057 DOI: 10.1186/s12967-023-04746-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Liquid biopsy provides a non-invasive approach that enables detecting circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) using blood specimens and theoretically benefits early finding primary tumor or monitoring treatment response as well as tumor recurrence. Despite many studies on these novel biomarkers, their clinical relevance remains controversial. This study aims to investigate the correlation between ctDNA, CTCs, and circulating tumor-derived endothelial cells (CTECs) while also evaluating whether mutation profiling in ctDNA is consistent with that in tumor tissue from lung cancer patients. These findings will help the evaluation and utilization of these approaches in clinical practice. METHODS 104 participants (49 with lung cancer and 31 with benign lesions) underwent CTCs and CTECs detection using integrating subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) strategy. The circulating cell-free DNA (cfDNA) concentration was measured and the mutational profiles of ctDNA were examined by Roche AVENIO ctDNA Expanded Kit (targeted total of 77 genes) by next generation sequencing (NGS) in 28 patients (20 with lung cancer and 8 with benign lesions) with highest numbers of CTCs and CTECs. Mutation validation in matched tumor tissue DNA was then performed in 9 patients with ctDNA mutations using a customized xGen pan-solid tumor kit (targeted total of 474 genes) by NGS. RESULTS The sensitivity and specificity of total number of CTCs and CTECs for the diagnosis of NSCLC were 67.3% and 77.6% [AUC (95%CI): 0.815 (0.722-0.907)], 83.9% and 77.4% [AUC (95%CI): 0.739 (0.618-0.860)]. The concentration of cfDNA in plasma was statistically correlated with the size of the primary tumor (r = 0.430, P = 0.022) and CYFRA 21-1 (r = 0.411, P = 0.041), but not with the numbers of CTCs and CTECs. In this study, mutations were found to be poorly consistent between ctDNA and tumor DNA (tDNA) in patients, even when numerous CTCs and CTECs were present. CONCLUSION Detection of CTCs and CTECs could be the potential adjunct tool for the early finding of lung cancer. The cfDNA levels are associated with the tumor burden, rather than the CTCs or CTECs counts. Moreover, the poorly consistent mutations between ctDNA and tDNA require further exploration.
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Affiliation(s)
- Jianzhu Xie
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Binjie Hu
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanping Gong
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sijia He
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Lin
- Department of Pathology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Huang
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jin Cheng
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Abstract
Current lung cancer screening protocols use low-dose computed tomography scans in selected high-risk individuals. Unfortunately, utilization is low, and the rate of false-positive screens is high. Peripheral biomarkers carry meaningful promise in diagnosing and monitoring cancer with added potential advantages reducing invasive procedures and improving turnaround time. Herein, the use of such blood-based assays is considered as an adjunct to further utilization and accuracy of lung cancer screening.
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Affiliation(s)
- Nathaniel Deboever
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Edwin J Ostrin
- Department of General Internal Medicine, Pulmonary Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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Martel A, Mograbi B, Romeo B, Gastaud L, Lalvee S, Zahaf K, Fayada J, Nahon-Esteve S, Bonnetaud C, Salah M, Tanga V, Baillif S, Bertolotto C, Lassalle S, Hofman P. Assessment of Different Circulating Tumor Cell Platforms for Uveal Melanoma: Potential Impact for Future Routine Clinical Practice. Int J Mol Sci 2023; 24:11075. [PMID: 37446253 DOI: 10.3390/ijms241311075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Liquid biopsy and circulating tumor cell (CTC) screening has gained interest over the last two decades for detecting almost all solid malignancies. To date, the major limitation in terms of the applicability of CTC screening in daily clinical practice is the lack of reproducibility due to the high number of platforms available that use various technologies (e.g., label-dependent versus label-free detection). Only a few studies have compared different CTC platforms. The aim of this study was to compare the efficiency of four commercially available CTC platforms (Vortex (VTX-1), ClearCell FX, ISET, and Cellsearch) for the detection and identification of uveal melanoma cells (OMM 2.3 cell line). Tumor cells were seeded in RPMI medium and venous blood from healthy donors, and then processed similarly using these four platforms. Melan-A immunochemistry was performed to identify tumor cells, except when the Cellsearch device was used (automated identification). The mean overall recovery rates (with mean recovered cells) were 39.2% (19.92), 22.2% (11.31), 8.9% (4.85), and 1.1% (0.20) for the ISET, Vortex (VTX-1), ClearCell FX, and CellSearch platforms, respectively. Although paramount, the recovery rate is not sufficient to assess a CTC platform. Other parameters, such as the purpose for using a platform (diagnosis, genetics, drug sensitivity, or patient-derived xenograft models), reproducibility, purity, user-friendliness, cost-effectiveness, and ergonomics, should also be considered before they can be used in daily clinical practice and are discussed in this article.
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Affiliation(s)
- Arnaud Martel
- Ophthalmology Department, University Hospital of Nice, Cote d'Azur University, 06 000 Nice, France
- Institute for Research on Cancer and Aging, Nice (IRCAN), FHU OncoAge, Cote d'Azur University, 06 000 Nice, France
| | - Baharia Mograbi
- Institute for Research on Cancer and Aging, Nice (IRCAN), FHU OncoAge, Cote d'Azur University, 06 000 Nice, France
| | - Barnabe Romeo
- Institute for Research on Cancer and Aging, Nice (IRCAN), FHU OncoAge, Cote d'Azur University, 06 000 Nice, France
| | - Lauris Gastaud
- Oncology Department, Antoine Lacassagne Cancer Center, 06 000 Nice, France
| | - Salome Lalvee
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Katia Zahaf
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Julien Fayada
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Sacha Nahon-Esteve
- Ophthalmology Department, University Hospital of Nice, Cote d'Azur University, 06 000 Nice, France
- Inserm, Biology and Pathologies of Melanocytes, Team1, Equipe labellisée Ligue 2020 and Equipe labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, 06 100 Nice, France
| | - Christelle Bonnetaud
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Myriam Salah
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Virginie Tanga
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Stéphanie Baillif
- Ophthalmology Department, University Hospital of Nice, Cote d'Azur University, 06 000 Nice, France
| | - Corine Bertolotto
- Inserm, Biology and Pathologies of Melanocytes, Team1, Equipe labellisée Ligue 2020 and Equipe labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, 06 100 Nice, France
| | - Sandra Lassalle
- Institute for Research on Cancer and Aging, Nice (IRCAN), FHU OncoAge, Cote d'Azur University, 06 000 Nice, France
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
| | - Paul Hofman
- Institute for Research on Cancer and Aging, Nice (IRCAN), FHU OncoAge, Cote d'Azur University, 06 000 Nice, France
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, FHU OncoAge, Cote d'Azur University, Biobank BB-0033-00025, 06 000 Nice, France
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Xu Y, Li Q, Lin Z, Lin Y. The value of folate receptor-positive circulating tumor cells in the diagnosis of lung cancer and its correlation with clinical characteristics. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:374-383. [PMID: 36977421 DOI: 10.1111/crj.13601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 01/04/2023] [Accepted: 02/23/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE The aim of this research is to investigate the feasibility of folate receptor-positive circulating tumor cells (FR+CTCs) as a biomarker for the diagnosis of malignant pulmonary nodules and the correlation between clinicopathological factors and FR+CTC levels. METHODS Patients initially diagnosed with one or more pulmonary nodules from a computed tomography scan were prospectively included. Three milliliters of peripheral blood was collected from each participant for FR+CTC analysis prior to surgery. Clinical and pathological parameters and FR+CTC levels were compared between patients with lung cancer and benign diseases. RESULTS Six hundred fifty-three patients had lung cancer and the other 124 had benign lung diseases based on pathological examinations of the resected specimens. The median FR+CTC value of the lung cancer group was 12.0 (95% CI 9.6-16.2) FU/3 mL and that of the benign group was 7.2 (95% CI 5.78-11.2) FU/3 mL. The difference was statistically significant (P < 0.0001). In a receiver operating characteristic analysis to distinguish the two groups, the area under curve of FR+CTC was 0.7457 (95% CI 0.6893-0.8021; P < 0.0001) using a cutoff of 8.65 FU/3 mL. The sensitivity was 86.37%, and the specificity was 74.19%. Combined with conventional serum tumor biomarkers, the area under curve was 0.922 (0.499-0.963). The sensitivity was 92.20%, and the specificity was 83.05%. FR+CTC levels were related to tumor staging (P4 < 0.001), the degree of tumor invasion both in single (P = 0.011) and multiple lesions (P = 0.022), pathological subtypes (P = 0.013), and maximum tumor diameter (P = 0.014). CONCLUSIONS FR+CTC is an effective and reliable biomarker for the diagnosis of lung cancer. Further, FR+CTC level is correlated with tumor staging, degree of invasion, pathological subtypes, and tumor size.
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Affiliation(s)
- Yunjian Xu
- Department of Clinical Lab, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qianjun Li
- Department of Clinical Lab, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhijian Lin
- Department of Clinical Lab, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yongping Lin
- Department of Clinical Lab, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Nøst TH, Skogholt AH, Urbarova I, Mjelle R, Paulsen E, Dønnem T, Andersen S, Markaki M, Røe OD, Johansson M, Johansson M, Grønberg BH, Sandanger TM, Sætrom P. Increased levels of microRNA-320 in blood serum and plasma is associated with imminent and advanced lung cancer. Mol Oncol 2023; 17:312-327. [PMID: 36337027 PMCID: PMC9892825 DOI: 10.1002/1878-0261.13336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/04/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Lung cancer (LC) incidence is increasing globally and altered levels of microRNAs (miRNAs) in blood may contribute to identification of individuals with LC. We identified miRNAs differentially expressed in peripheral blood at LC diagnosis and evaluated, in pre-diagnostic blood specimens, how long before diagnosis expression changes in such candidate miRNAs could be detected. We identified upregulated candidate miRNAs in plasma specimens from a hospital-based study sample of 128 patients with confirmed LC and 62 individuals with suspected but confirmed negative LC (FalsePos). We then evaluated the expression of candidate miRNAs in pre-diagnostic plasma or serum specimens of 360 future LC cases and 375 matched controls. There were 1663 miRNAs detected in diagnostic specimens, nine of which met our criteria for candidate miRNAs. Higher expression of three candidates, miR-320b, 320c, and 320d, was associated with poor survival, independent of LC stage and subtype. Moreover, miR-320c and miR-320d expression was higher in pre-diagnostic specimens collected within 2 years of LC diagnosis. Our results indicated that elevated levels of miR-320c and miR-320d may be early indications of imminent and advanced LC.
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Affiliation(s)
- Therese Haugdahl Nøst
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic EpidemiologyNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | - Anne Heidi Skogholt
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic EpidemiologyNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | - Ilona Urbarova
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | - Robin Mjelle
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic EpidemiologyNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Department of Clinical and Molecular MedicineNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Bioinformatics Core FacilityNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | - Erna‐Elise Paulsen
- Department of Clinical Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
- Department of PulmonologyUniversity Hospital of North NorwayTromsøNorway
| | - Tom Dønnem
- Department of Clinical Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
- Department of OncologyUniversity Hospital of North NorwayTromsøNorway
| | - Sigve Andersen
- Department of Clinical Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
- Department of OncologyUniversity Hospital of North NorwayTromsøNorway
| | | | - Oluf Dimitri Røe
- Department of Clinical and Molecular MedicineNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Cancer Clinic, Levanger HospitalNord‐Trøndelag Health TrustLevangerNorway
| | | | | | - Bjørn Henning Grønberg
- Department of Clinical and Molecular MedicineNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Department of Oncology, St. Olavs HospitalTrondheim University HospitalNorway
| | - Torkjel Manning Sandanger
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | - Pål Sætrom
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic EpidemiologyNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Department of Clinical and Molecular MedicineNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Bioinformatics Core FacilityNTNU – Norwegian University of Science and TechnologyTrondheimNorway
- Department of Computer ScienceNorwegian University of Science and TechnologyTrondheimNorway
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Mastromarino MG, Parini S, Azzolina D, Habib S, De Marni ML, Luise C, Restelli S, Baietto G, Trisolini E, Massera F, Papalia E, Bora G, Carbone R, Casadio C, Boldorini R, Rena O. Liquid Biopsy Detecting Circulating Tumor Cells in Patients with Non-Small Cell Lung Cancer: Preliminary Results of a Pilot Study. Biomedicines 2023; 11:biomedicines11010153. [PMID: 36672660 PMCID: PMC9855397 DOI: 10.3390/biomedicines11010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Lung cancer is still the leading cause of cancer-related death worldwide. Interest is growing towards early detection and advances in liquid biopsy to isolate circulating tumor cells (CTCs). This pilot study aimed to detect epithelial CTCs in the peripheral blood of early-stage non-small cell lung cancer (NSCLC) patients. We used Smart BioSurface® (SBS) slide, a nanoparticle-coated slide able to immobilize viable nucleated cellular fraction without pre-selection and preserve cell integrity. Forty patients undergoing lung resection for NSCLC were included; they were divided into two groups according to CTC value, with a cut-off of three CTCs/mL. All patients were positive for CTCs. The mean CTC value was 4.7(± 5.8 S.D.) per ml/blood. In one patient, next generation sequencing (NGS) analysis of CTCs revealed v-raf murine sarcoma viral oncogene homolog B(BRAF) V600E mutation, which has also been identified in tissue biopsy. CTCs count affected neither overall survival (OS, p = 0.74) nor progression-free survival (p = 0.829). Multivariable analysis confirmed age (p = 0.020) and pNodal-stage (p = 0.028) as negative predictors of OS. Preliminary results of this pilot study suggest the capability of this method in detecting CTCs in all early-stage NSCLC patients. NGS on single cell, identified as CTC by immunofluorescence staining, is a powerful tool for investigating the molecular landscape of cancer, with the aim of personalized therapies.
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Affiliation(s)
- Maria Giovanna Mastromarino
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
- Correspondence: ; Tel.: +39-0321/3732111
| | - Sara Parini
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Danila Azzolina
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Sara Habib
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | | | | | | | - Guido Baietto
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Elena Trisolini
- Division of Pathology, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Fabio Massera
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Esther Papalia
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Giulia Bora
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | | | - Caterina Casadio
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
| | - Renzo Boldorini
- Division of Pathology, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Ottavio Rena
- Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, 28100 Novara, Italy
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
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7
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Manjunath Y, Suvilesh KN, Mitchem JB, Avella Patino DM, Kimchi ET, Staveley-O'Carroll KF, Pantel K, Yi H, Li G, Harris PK, Chaudhuri AA, Kaifi JT. Circulating Tumor-Macrophage Fusion Cells and Circulating Tumor Cells Complement Non-Small-Cell Lung Cancer Screening in Patients With Suspicious Lung-RADS 4 Nodules. JCO Precis Oncol 2022; 6:e2100378. [PMID: 35417204 PMCID: PMC9012602 DOI: 10.1200/po.21.00378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Low-dose computed tomography (LDCT) screening of high-risk patients decreases lung cancer-related mortality. However, high false-positive rates associated with LDCT result in unnecessary interventions. To distinguish non-small-cell lung cancer (NSCLC) from benign nodules, in the present study, we integrated cellular liquid biomarkers in patients with suspicious lung nodules (lung cancer screening reporting and data system [Lung-RADS] 4). METHODS Prospectively, 7.5 mL of blood was collected from 221 individuals (training set: 90 nonscreened NSCLC patients, 74 high-risk screening patients with no/benign nodules [Lung-RADS 1-3], and 20 never smokers; validation set: 37 patients with suspicious nodules [Lung-RADS 4]). Circulating tumor cells (CTCs), CTC clusters, and tumor-macrophage fusion (TMF) cells were identified by blinded analyses. Screening patients underwent a median of two LDCTs (range, 1-4) with a median surveillance time of 30 (range, 11-50) months. RESULTS In the validation set of 37 Lung-RADS 4 patients, all circulating cellular biomarker counts (P < .005; Wilcoxon test) and positivity rates were significantly higher in 23 biopsy-proven NSCLC patients (CTCs: 23 of 23 [100%], CTC clusters: 6 of 23 [26.1%], and TMF cells: 15 of 23 [65.2%]) than in 14 patients with biopsy-proven benign nodules (6 of 14 [42.9%], 0 of 14 [0%], and 2 of 14 [14.3%]). On the basis of cutoff values from the training set, logistic regression with receiver operating characteristic and area under the curve analyses demonstrated that CTCs (sensitivity: 0.870, specificity: 1.0, and area under the curve: 0.989) and TMF cells (0.652; 0.880; 0.790) complement LDCT in diagnosing NSCLC in Lung-RADS 4 patients. CONCLUSION Cellular liquid biomarkers have a potential to complement LDCT interpretation of suspicious Lung-RADS 4 nodules to distinguish NSCLC from benign lung nodules. A future prospective, large-scale, multicenter clinical trial should validate the role of cellular liquid biomarkers in improving diagnostic accuracy in high-risk patients with Lung-RADS 4 nodules.
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Affiliation(s)
- Yariswamy Manjunath
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Kanve Nagaraj Suvilesh
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO
| | - Jonathan B Mitchem
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO.,Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | - Diego M Avella Patino
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Eric T Kimchi
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO.,Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | - Kevin F Staveley-O'Carroll
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO.,Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | - Klaus Pantel
- Institute for Tumor Biology, University of Hamburg, Hamburg, Germany
| | - Huang Yi
- Departments of Radiation Oncology, Genetics, and Computer Science and Engineering, Washington University School of Medicine, St Louis, MO
| | - Guangfu Li
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Peter K Harris
- Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.,Departments of Radiation Oncology, Genetics, and Computer Science and Engineering, Washington University School of Medicine, St Louis, MO
| | - Aadel A Chaudhuri
- Siteman Cancer Center, Washington University School of Medicine, St Louis, MO.,Departments of Radiation Oncology, Genetics, and Computer Science and Engineering, Washington University School of Medicine, St Louis, MO
| | - Jussuf T Kaifi
- Department of Surgery, Ellis Fischel Cancer Center, University of Missouri-Columbia, Columbia, MO.,Harry S. Truman Memorial Veterans' Hospital, Columbia, MO.,Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
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