<p>Circulating Tumor Cells as a Screening and Diagnostic Marker for Early-Stage Non-Small Cell Lung Cancer</p>

Abstract

Background: Circulating tumor cells (CTCs) have become potential diagnostic biomarker for several types of cancer, including lung cancer. In this study, we aim to determine whether CTCs detected by CellCollector can be used for early-stage diagnosis of lung cancer. Methods: In this study, we recruited 64 volunteers, among whom 44 were suspected lung cancer patients requiring surgical treatment and 20 were healthy volunteers. We simultaneously analyzed PD-L1 expression in CTCs isolated using the GILUPI CellCollector and copy number variation by next-generation sequencing (NGS). Results: We enrolled a total of 44 patients with suspected lung cancer who required surgery and 20 healthy volunteers. The patients were classified into 4 groups based on their pathological results: benign disease, in situ cancer, microinvasive, and invasive. The CTCs detection rate for each group was 10.00% (1/10), 45% (5/11), 50% (7/14), and 67% (6/9), respectively. Among the patients with lung cancer, the CTCs detection rate increased with disease progression. The rate of CTCs positivity was 52.94% (18/34) in patients who were diagnosed with lung cancer by pathology and 10% (1/10) in patients with benign disease. CTCs were not detected in the control group. The area under the receiver operating characteristic (ROC) curve, a measure for distinguishing patients with primary lung cancer, was 0.715 (95% CI 0.549-0.880, P=0.041). The sensitivity and specificity of the in vivo CTCs detection strategy for the diagnosis of early-stage lung cancer were 52.94% and 90%, respectively. CTCs were associated with clinical pathology but not with the size and location of the nodules. Conclusion: CTCs isolation using the CellCollector in vivo detection method might be effective for distinguishing between benign and malignant nodules and may be used for early-stage diagnosis of lung cancer.

The Role of Liquid Biopsy in Early Diagnosis of Lung Cancer

“…He and collaborators demonstrated that this strategy was able to identify not only 73.3% of the ad.vanced LC patients as reported before (157), but also 15.6% of the ground-glass nodules (146). In two later studies including early LC patients, sensitivity values of 53-63% were reached (147,148). Remarkably, the captured CTCs can be separated for NGS or PD-L1 analysis (146)(147)(148).…”

Recognition of the organ-specific mutations in metastatic breast cancer by circulating tumor cells isolated in vivo.

“…The superiority of CellCollector was also shown in research done in lung cancer and prostate cancer patients [17,19,20]. Moreover, CTCs captured using this in vivo assay can be easily isolated for downstream molecular characterization including NGS, which could provide additional genetic information useful for future targeted therapy developments [17,21,22].…”

Role of circulating tumor cells in diagnosis of lung cancer: a systematic review and meta-analysis

“…Twenty-one studies 13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] with 3997 subjects, including 2714 lung cancer patients, were recruited in this meta-analysis. The remaining 1283 individuals belonged to the control groups, comprising healthy volunteers in 15 studies 13,[16][17][18][19]21,[23][24][25]27,28,[30][31][32][33] and patients with benign lung disease in 11 studies. 16,18,19,22,27,29,30,[32][33][34][35] Zhou et al 35 and Chen et al 18 included two cohorts and reported the sensitivities and specificities separately, referred to as Zh...…”