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L. Wang
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P3.02 - Biology/Pathology (ID 620)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.02-014a - Diagnostic Value of FR<sup>+</sup>-CTCs Detected by LT-PCR for Lung Cancer in SPN and Tumor Invasiveness in Adenocarcinoma (T≪3cm) (ID 8805)
09:30 - 09:30 | Author(s): L. Wang
- Abstract
Background:
To investigate the diagnostic value of folate receptor (FR)-positive circulating tumor cells (CTCs) detected by ligand-targeted polymerase chain reaction (LT-PCR) in distinguishing lung cancer from lung benign diseases in patients with solitary pulmonary nodules (SPN), and to identify the tumor invasiveness in lung adenocarcinomas of 3cm or smaller.
Method:
We enriched FR[+]-CTCs by immunomagnetic depletion of leukocytes and labeling with a conjugate of a tumor specific ligand folic acid and a synthesized oligonucleotide. The bounded conjugates were then analyzed by quantitative PCR (qPCR). Blood samples were collected from 319 lung cancer patients (257 adenocarcinoma patients), 120 benign patients. Including 257 lung adenocarcinoma patients, 41 were adnocarcinoma in situ (AIS), 53 were microinvasive adnocarcinoma (MIA), and 163 were invasive adnocarcinoma (INV). The clinicopathological characteristics were analyzed from medical records.
Result:
Patients were randomly assigned to a training set and a validation set. FR[+]-CTC levels of patients with lung cancer were significantly higher than patients with benign lung diseases (p=0.000). With a threshold of 8.74 CTC units, FR[+]-CTC showed a markedly sensitivity (training set, 72.05%; validation set, 74.36%) and specificity (training set, 80.9%; validation set 77.42%) in the diagnosis of lung cancer. When compared with established clinical biomarkers including carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), CA-125, squamous cell related antigen (SCC), and neuron-specific enolase (NSE), FR[+]-CTC showed the highest area under the receiver operative characteristic curve (training set, 0.754; validation set 0.765). With a threshold of 9.051 CTC units, FR[+]-CTC showed a comparable sensitivity (training set, 77.50%; validation set, 79.07%) and specificity (training set, 61.24%; validation set 60%) to CEA and CA-125 in distinguishing the AIS from INV. Notably, the combination of FR[+]-CTC with established clinical biomarkers including CEA, CYFRA21-1, CA-125, SCC and NSE could significantly improve the diagnostic efficiency.
Conclusion:
LT-PCR based FR[+]-CTC detection platform is reliable to be used as a biomarker for the diagnosis of lung cancer in patients with SPN, moreover, the FR[+]-CTC level might be a promising biomarker to identify the tumor invasiveness in lung adenocarcinomas of 3cm or smaller.
