Clinical and Translational Research
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2021; 9(12): 2721-2730
Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2721
Circulating tumor cells with epithelial-mesenchymal transition markers as potential biomarkers for the diagnosis of lung cancer
Sha-Sha Jiang, Chun-Guo Mao, Yong-Geng Feng, Bin Jiang, Shao-Lin Tao, Qun-You Tan, Bo Deng
Sha-Sha Jiang, Chun-Guo Mao, Yong-Geng Feng, Bin Jiang, Shao-Lin Tao, Qun-You Tan, Bo Deng, Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing 400042, China
Author contributions: Jiang SS and Mao CG performed the research and wrote the paper; Feng YG and Jiang B designed the research and supervised the study; Tao SL and Tan QY designed the research and contributed to the analyses; Deng B provided clinical advice and supervised the report.
Supported by National Natural Science Foundation of China, No. 81572285; The Natural Science Foundation of Chongqing City, No. cstc2018jcyjAX0592; and The Army Medical University Clinical Medical Research Talent Training Program, No. 2018XLC3062.
Institutional review board statement: The study protocol was reviewed and approved by the Ethics Committee of Daping Hospital, Army Medical University 2019, No. 183.
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/. The registration identification number is NCT02951897.
Informed consent statement: All patients who agreed to participate in the study signed an informed consent.
Conflict-of-interest statement: The authors declare that they have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Deng, MD, PhD, Professor, Surgeon, Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, No. 10 Changjiang Branch Street, Yuzhong District, Chongqing 400042, China. dengbo@tmmu.edu.cn
Received: November 20, 2020
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
ARTICLE HIGHLIGHTS
Research background

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).

Research motivation

CTCs categorized by epithelial-mesenchymal transition (EMT) markers have diagnostic value in LC and ground-glass opacities (GGO) patients.

Research objectives

To clarify the diagnostic value of CTCs categorized by the expression of EMT markers in LC and GGO patients

Research methods

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.

Research results

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%.

Research conclusions

CTC detection is valuable for distinguishing LC as well as GGO patients from controls.

Research perspectives

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.