Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2721
Peer-review started: November 20, 2020
First decision: February 12, 2021
Revised: February 19, 2021
Accepted: March 4, 2021
Article in press: March 4, 2021
Published online: April 26, 2021
Processing time: 145 Days and 23.4 Hours
Circulating tumor cells (CTCs) can be clustered into three subtypes according to surface biomarkers. CTC detection has clinical implications in the diagnosis of lung cancer (LC).
CTCs categorized by epithelial-mesenchymal transition (EMT) markers have diagnostic value in LC and ground-glass opacities (GGO) patients.
To clarify the diagnostic value of CTCs categorized by the expression of EMT markers in LC and GGO patients
Of the 106 patients with lung adenocarcinoma comprising the study cohort, 42 had GGO and 64 had solid lesions; 11 patients with benign tumors and 17 healthy controls were included as controls. Total CTCs and CTCs with both markers (E&M-CTCs) of these patients were detected, the diagnostic value of CTCs categorized by the expression of EMT markers. CytoploRare technique was used in 20 cases and 18 controls for validation.
Total CTCs and E&M-CTCs were significantly more frequent in LC cases than in benign or healthy controls. The area under the receiver operating characteristic curve of total CTCs and E&M-CTCs was > 0.8 and > 0.75, respectively. The combined sensitivity of total-CTCs and E&M-CTCs was 85.85% for LC patients (80.95% for GGO patients) and the specificity was 78.57%.
CTC detection is valuable for distinguishing LC as well as GGO patients from controls.
Epithelial (E)-, mesenchymal (M)-, and E&M markers can be identified in CTC. Therefore, CTCs were clustered into three subtypes, as per the markers on CTC, i.e. E-CTC, M-CTC and E&M-CTC. Detection of E&M-CTC has good diagnostic value in distinguishing lung cancer, providing a new method to discriminate between malignant and benign pulmonary node in clinical practice.