循环肿瘤细胞在甲状腺癌患者中的诊断价值：一项对1478例患者的回顾性研究
Diagnostic value of circulating tumor cells in patients with thyroid cancer: a retrospective study of 1478 patients.
作者信息
Zeng Qingxin, Zhong Haifeng, Rao Hui, Wang Yuedong
机构信息
Department of Thyroid Surgery, Meizhou People's Hospital (Huangtang Hospital)/Meizhou Academy of Medical Sciences, No. 63, Huangtang Road, Meijiang District, Meizhou, 514031, China.
Department of Laboratory Medicine, Meizhou People's Hospital (Huangtang Hospital)/Meizhou Academy of Medical Sciences, Meizhou, China.
出版信息
Discov Oncol. 2024 Apr 12;15(1):114. doi: 10.1007/s12672-024-00976-4.
BACKGROUND
Circulating tumor cell (CTC) detection is one form of liquid biopsy. It is a novel technique that is beginning to be applied in the field of thyroid cancer. The present study was designed to evaluate the diagnostic value of CTCs in patients with thyroid cancer.
METHODS
A total of 1478 patients were retrospectively analyzed and divided into malignant group (n = 747) and benign group (n = 731). Peripheral blood was collected, and CTCs were enriched and quantified before surgery. The baseline data of the two groups were matched by Propensity Score Matching (PSM). Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency of different indicators for thyroid cancer. The malignant group before PSM was further divided into subgroups according to the BRAF V600E mutation and lymphatic metastasis (N stage), and the number of CTCs in different subgroups was compared.
RESULTS
After 1:1 PSM, baseline characteristics of the malignant group and benign group were matched and assigned 315 cases in each group. The number of CTCs and the TPOAb values were comparable in the two groups (p > 0.05). The TgAb values [1.890 (1.110 - 16.010) vs 1.645 (1.030 - 7.073) IU/mL, p = 0.049] were significantly higher in the malignant group than in the benign group. After PSM, ROC analyses showed that the areas under the curve (AUCs) of CTC, TgAb and ultrasound were 0.537 (sensitivity 65.6%, specificity 45.8%), 0.546 (sensitivity 40.0%, specificity 70.8%) and 0.705 (sensitivity 77.1%, specificity 63.2%), respectively. The AUCs of the combined detection of 'CTC + ultrasound' (combine 1) and the combined detection of 'CTC + TgAb + ultrasound' (combine 2) were 0.718 (sensitivity 79.3%, specificity 61.7%) and 0.724 (sensitivity 78.0%, specificity 63.3%), respectively. The AUC of ultrasound was significantly higher than CTC (p < 0.001). There was no statistically significant difference in AUC between combination 1 and ultrasound, and between combination 2 and ultrasound (p > 0.05). The number of CTCs between the N0 and N1 subgroups, and between the BRAF mutant and BRAF wild subgroups was comparable (p > 0.05).
CONCLUSIONS
As an emerging and noninvasive testing tool, the efficacy of CTCs in diagnosing thyroid cancer is limited.
背景
循环肿瘤细胞（CTC）检测是液体活检的一种形式。它是一种新兴技术，开始应用于甲状腺癌领域。本研究旨在评估CTC在甲状腺癌患者中的诊断价值。
方法
回顾性分析1478例患者，分为恶性组（n = 747）和良性组（n = 731）。术前采集外周血，富集并定量CTC。两组的基线数据通过倾向得分匹配（PSM）进行匹配。采用受试者操作特征（ROC）曲线评估不同指标对甲状腺癌的诊断效率。PSM前的恶性组根据BRAF V600E突变和淋巴转移（N分期）进一步分为亚组，比较不同亚组的CTC数量。
结果
1:1 PSM后，恶性组和良性组的基线特征匹配，每组各分配315例。两组的CTC数量和TPOAb值相当（p > 0.05）。恶性组的TgAb值[1.890（1.110 - 16.010）对1.645（1.030 - 7.073）IU/mL，p = 0.049]显著高于良性组。PSM后，ROC分析显示，CTC、TgAb和超声的曲线下面积（AUC）分别为0.537（敏感性65.6%，特异性45.8%）、0.546（敏感性40.0%，特异性70.8%）和0.705（敏感性77.1%，特异性63.2%）。“CTC + 超声”联合检测（组合1）和“CTC + TgAb + 超声”联合检测（组合2）的AUC分别为0.718（敏感性79.3%，特异性61.7%）和0.724（敏感性78.0%，特异性63.3%）。超声的AUC显著高于CTC（p < 0.001）。组合1与超声之间以及组合2与超声之间的AUC无统计学显著差异（p > 0.05）。N0和N1亚组之间以及BRAF突变和BRAF野生亚组之间的CTC数量相当（p > 0.05）。
结论
作为一种新兴的非侵入性检测工具，CTC诊断甲状腺癌的效能有限。
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