Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Thoracic Surgery, Linqu County People's hospital, Weifang, China.
J Clin Lab Anal. 2022 Oct;36(10):e24654. doi: 10.1002/jcla.24654. Epub 2022 Aug 10.
The use of FR + CTC to distinguish lung cancer from benign lung disease has been well studied. However, the effective method to differentiate precursor glandular lesions from benign/malignant pulmonary diseases is rare.
380 patients with indeterminate pulmonary nodules were prospectively recruited. Peripheral blood samples were collected from all participants before surgery for analyzing FR + CTC levels. The performance of FR + CTC to identify lung precursor lesions were analyzed by receiver operating characteristic (ROC) curve.
FR + CTC can effectively differentiate precursor from benign pulmonary diseases in all included patients (cutoff: 9.22 FU/3 ml, AUC = 0.807, (p < 0.0001, sensitivity: 69.17%, specificity: 82.46%) and patients with single pulmonary lesion (cutoff: 9.03 FU/3 ml, AUC = 0.842, p = 0.0001, sensitivity: 75.20%, specificity: 83.00%). However, FR + CTC cannot differentiate precursor from benign pulmonary diseases in multiple lesions patients (p = 0.110). FR + CTC neither differentiate precursor from malignant pulmonary lesions in all included patients (p = 0.715), single nor multiple lesions patients (p = 0.867, p = 0.692, respectively). Total number of pulmonary nodules, MTD, location (lower vs upper) were independent risk factors for malignancy (AOR, 95% CI: 3.104 (1.525, 6.316), 3.148 (1.722, 5.754), 2.098 (1.132, 3.888), respectively.
Preoperative FR + CTC can be identified in precursor glandular lesions and utilized to differentiate from benign pulmonary diseases. Total number of pulmonary nodules, MTD, location (lower vs upper) were independent risk factors for malignancy.
使用 FR+CTC 来区分肺癌与良性肺部疾病的方法已得到充分研究。然而，用于区分肺前体腺病变与良性/恶性肺部疾病的有效方法却很少。
前瞻性招募了 380 名肺部结节患者。所有患者在手术前采集外周血样，用于分析 FR+CTC 水平。通过接收者操作特征（ROC）曲线分析 FR+CTC 识别肺前体病变的性能。
FR+CTC 可有效区分所有纳入患者的前体与良性肺部疾病（截断值：9.22 FU/3ml，AUC=0.807，p<0.0001，灵敏度：69.17%，特异性：82.46%）和单发肺部病变患者（截断值：9.03 FU/3ml，AUC=0.842，p=0.0001，灵敏度：75.20%，特异性：83.00%）。然而，FR+CTC 无法区分多发肺部病变患者的前体与良性肺部疾病（p=0.110）。FR+CTC 也无法区分所有纳入患者的前体与恶性肺部病变（p=0.715），单发或多发病变患者（p=0.867，p=0.692）。肺部结节总数、MTD、位置（下叶与上叶）是恶性的独立危险因素（OR，95%CI：3.104（1.525，6.316），3.148（1.722，5.754），2.098（1.132，3.888））。
术前 FR+CTC 可用于识别前体腺病变，并用于与良性肺部疾病区分。肺部结节总数、MTD、位置（下叶与上叶）是恶性的独立危险因素。
