Wang Huanrong, Liu Lei, Yan Jiaqin, Ma Wang, Du Yabing, Zhang Tengfei
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2023 Jan 19;12:1097816. doi: 10.3389/fonc.2022.1097816. eCollection 2022.
The folate receptor-positive circulating tumor cell (FR-CTC) count can be used to improve the diagnosis rate of lung cancer. The lymphocyte count (LC) and derived neutrophil-to-lymphocyte ratio (dNLR) are involved in inflammatory processes. Whether the FR-CTC count combined with the dNLR or LC is helpful for diagnosing lung cancer recurrence is not clear. Sixty-eight patients who were initially diagnosed with lung cancer and received first-line treatment were included. The clinicopathological characteristics, routine blood examination results and CTC examination results of the patients were collected. The role of the complete blood count and FR-CTC count in lung cancer treatment response and prognosis was analyzed. The FR-CTC count after treatment was significantly correlated with the T stage (=0.005). Multivariate analysis showed that the pathological type and FR-CTC count were independent predictors of disease-or progression-free survival (DFS/PFS) in patients with lung cancer (=0.010 and =0.030, respectively). The FR-CTC count, LC and dNLR predicted the recurrence of lung cancer (sensitivity and specificity of the FR-CTC count, 69.2% and 71.4%; the LC, 50.0% and 88.5%; and the dNLR, 50.0% and 88.1%, respectively). The FR-CTC count combined with the LC or dNLR improved the diagnostic rate of lung cancer recurrence (sensitivity and specificity of the FR-CTC count plus the LC, 53.8% and 90.5%, and the FR-CTC count plus the dNLR, 73.1% and 73.8%, respectively). When these three indicators were combined to predict lung cancer recurrence, the AUC value was 0.817. The FR-CTC count combined with the dNLR and/or LC after treatment can improve the diagnostic rate of lung cancer recurrence. A higher FR-CTC count predicts worse DFS/PFS in patients with lung cancer.
叶酸受体阳性循环肿瘤细胞（FR-CTC）计数可用于提高肺癌的诊断率。淋巴细胞计数（LC）和衍生的中性粒细胞与淋巴细胞比值（dNLR）参与炎症过程。FR-CTC计数联合dNLR或LC是否有助于诊断肺癌复发尚不清楚。纳入68例初诊为肺癌并接受一线治疗的患者。收集患者的临床病理特征、血常规检查结果和CTC检查结果。分析血常规和FR-CTC计数在肺癌治疗反应和预后中的作用。治疗后的FR-CTC计数与T分期显著相关（=0.005）。多因素分析显示，病理类型和FR-CTC计数是肺癌患者疾病无进展生存期（DFS/PFS）的独立预测因素（分别为=0.010和=0.030）。FR-CTC计数、LC和dNLR可预测肺癌复发（FR-CTC计数的敏感性和特异性分别为69.2%和71.4%；LC分别为50.0%和88.5%；dNLR分别为50.0%和88.1%）。FR-CTC计数联合LC或dNLR可提高肺癌复发的诊断率（FR-CTC计数加LC的敏感性和特异性分别为53.8%和90.5%，FR-CTC计数加dNLR分别为73.1%和73.8%）。当这三个指标联合预测肺癌复发时，AUC值为0.817。治疗后FR-CTC计数联合dNLR和/或LC可提高肺癌复发的诊断率。较高的FR-CTC计数预示肺癌患者的DFS/PFS较差。
