Application of folate receptor-positive circulating tumor cells in auxiliary diagnosis of malignant pulmonary nodules

Abstract

Objective To evaluate the practical value of detecting folate receptor (FR)-positive circulating tumor cells (CTC) in clinical diagnosis of benign and malignant lung nodules. Methods A total of 288 patients with pulmonary nodules admitted in our hospital from May 2017 to April 2018 were enrolled in this study. FR-targeted CTC technology was used to quantitatively detect CTC content in peripheral blood samples. The results were analyzed with the postoperative pathological results to evaluate the accuracy and feasibility of the detection in the auxiliary diagnosis of lung malignant tumors. Results With a cut-off value of 8.7 Folate Units/3 mL as the threshold, the CTC content was significantly higher in the 136 patients with pulmonary malignant tumor than the 152 patients with pulmonary benign disease (P < 0.05). Among the 136 patients with pathologically diagnosed pulmonary malignant tumors, FR-positive CTC were observed in 106 patients. In the 152 patients with benign nodules, 44 cases showed false positive CTC results. In general, the sensitivity and specificity of FR-positive CTC detection was 78.7% and 71.1%, respectively in the detection of pulmonary malignant tumors. Furthermore, the sensitivity reached 76.9% in stage I lung cancer (70/91), and all 9 cases of lung cancer in situ were positive in the detection. Compared with tumor markers and CT examinations, FR-positive CTC detection was of higher auxiliary diagnostic value for early lung cancer. Conclusion FR-positive CTC detection can be used to screen benign and malignant lung nodules, and has a good value in the diagnosis of early-stage pulmonary malignant tumors.

Keywords

• folate receptor
• circulating tumor cells
• pulmonary nodules
• lung cancer
• auxiliary diagnosis