[Diagnostic Value of Folate Receptor-positive Circulating Tumor Cell in Lung Cancer: A Pilot Study]

Circulating tumor cell levels and carcinoembryonic antigen: An improved diagnostic method for lung adenocarcinoma

BACKGROUND

The aim of this study was to determine a correlation between benign and malignant lung solitary pulmonary nodules (SPN), and analyze the association between circulating tumor cell (CTC) levels and different subtypes of lung adenocarcinoma.

METHODS

A total of 200 patients (80 with SPNs and 120 diagnosed with lung cancer) were included in the study. The CTC levels were quantified by identifying the folate receptor on the surface of tumor cells; clinical tumor specific markers were detected by biochemical immunization. The content of peripheral blood CTCs in benign and malignant lung SPN patients was detected and the differences in preoperative CTC levels in different pathological subtypes were analyzed. Based on the collected data, receiver operating characteristic curves were calculated and the rate of lung cancer was predicted.

RESULTS

The peripheral blood CTC levels in patients with malignant lung SPNs were higher than in patients with benign SPNs. The maximum nodule diameter, carcinoembryonic antigen, and CTC levels were independent risk factors for malignant lung SPNs. The peripheral blood CTC levels in patients with stage III-IV lung adenocarcinoma were higher than in stage I-II patients. The peripheral blood CTC levels in patients with microinvasive and invasive adenocarcinoma were higher than in adenocarcinoma in situ patients. The CTC levels in the peripheral blood of patients with maximum tumor diameter > 2 cm were higher than in patients with tumors < 2 cm.

CONCLUSION

The detection of CTCs can be used as a biomarker for screening SPNs and diagnosing early-stage lung cancer. Using the combination of CTC levels and CEA significantly improves the efficacy of lung adenocarcinoma diagnosis.

Practical value of identifying circulating tumor cells to evaluate esophageal squamous cell carcinoma staging and treatment efficacy

Background

This study was conducted to investigate the correlation between clinicopathological features and post‐therapeutic response in esophageal squamous cell carcinoma (ESCC) patients. Peripheral blood circulating tumor cells (CTCs) expressing epithelial‐mesenchymal transition markers were identified.

Methods

Peripheral blood samples were collected from 71 patients with newly diagnosed ESCC and 40 healthy volunteers. CTCs were isolated using CanPatrol CTC enrichment technology. RNA‐fluorescent in situ hybridization was used to phenotype the CTCs on the basis of epithelial and/or mesenchymal markers.

Results

The median mesenchymal CTC counts in 71 patients were: 0 in 19 stage I patients, 2 in 31 stage II, and 3 in 21 stage III/IV. The overall diagnostic performance of total CTCs to correctly identify ESCC patients was 0.991. We observed a correlation between increases in tumor size or advanced stage and an increased number of mesenchymal CTCs (P < 0.05). Thirty‐nine patients were administered two cycles of neoadjuvant chemotherapy and their therapeutic response was evaluated: 2 complete response, 20 partial response, 13 stable disease, and 4 progressive disease. After treatment, the positive rate of mesenchymal CTCs was 70.6% in the progressive and stable disease group versus 36.4% in the complete and partial response group (P = 0.05).

Conclusion

The results showed that mesenchymal CTC count is related to ESCC clinical stage and the efficacy of neoadjuvant chemotherapy.