Gao Yang, Fan Wan-Hung, Duan Chaohui, Zhao Wenhe, Zhang Jun, Kang Xixiong
Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China.
Front Oncol. 2021 May 19;11:643003. doi: 10.3389/fonc.2021.643003. eCollection 2021.
Ultrasound (US) and mammogram (MMG) are the two most common breast cancer (BC) screening tools. This study aimed to assess how the combination of circulating tumor cells (CTC) with US and MMG would improve the diagnostic performance.
CTC detection and imaging examinations, US and MMG, were performed in 238 treatment-naive BC patients, 217 patients with benign breast diseases (BBD), and 20 healthy females. Correlations of CTC, US and MMG with patients' clinicopathological characteristics were evaluated. Diagnostic performances of CTC, US and MMG were estimated by the receiver operating characteristic curves.
CTC, US and MMG could all distinguish BC patients from the control (p < 0.0001). Area under curve (AUC) of CTC, US and MMG are 0.855, 0.861 and 0.759, respectively. While US has the highest sensitivity of 0.79, CTC and MMG have the same specificity of 0.92. Notably, CTC has the highest accuracy of 0.83. Combination with CTC increases the AUC of US and MMG to 0.922 and 0.899, respectively. Combining MMG with CTC or US increases the sensitivity of MMG to 0.87, however "CTC + MMG" has a higher specificity of 0.85. "CTC + US" performs the best in BC diagnosis, followed by "CTC + MMG" and then "US + MMG".
CTC can be used as a diagnostic aid for BC screening. Combination with CTC increases the diagnostic potency of conventional BC screening imaging examinations, US and MMG, in BC diagnosis, especially for MMG.
超声（US）和乳房X线摄影（MMG）是两种最常用的乳腺癌（BC）筛查工具。本研究旨在评估循环肿瘤细胞（CTC）与US和MMG联合使用如何提高诊断性能。
对238例未经治疗的BC患者、217例乳腺良性疾病（BBD）患者和20例健康女性进行CTC检测及影像学检查，即US和MMG。评估CTC、US和MMG与患者临床病理特征的相关性。通过受试者工作特征曲线评估CTC、US和MMG的诊断性能。
CTC、US和MMG均能将BC患者与对照组区分开来（p<0.0001）。CTC、US和MMG的曲线下面积（AUC）分别为0.855、0.861和0.759。虽然US的灵敏度最高，为0.79，但CTC和MMG的特异性相同，均为0.92。值得注意的是，CTC的准确率最高，为0.83。与CTC联合使用可使US和MMG的AUC分别提高至0.922和0.899。将MMG与CTC或US联合使用可使MMG的灵敏度提高至0.87，然而“CTC+MMG”的特异性更高，为0.85。“CTC+US”在BC诊断中表现最佳，其次是“CTC+MMG”，然后是“US+MMG”。
CTC可作为BC筛查的诊断辅助手段。与CTC联合使用可提高传统BC筛查影像学检查US和MMG在BC诊断中的诊断效能，尤其是对MMG。
