Diagnostic value of human circulating tumor cell detection for non-small cell lung cancer

Objective To estimate the diagnostic value of circulating tumor cell detection for non-small cell lung cancer. Methods A Non-intervention clinical study was conducted in this research. From October 2014 to April 2015, totally 162 NSCLC who presented at Thoracic Surgery Department, 119 benign pulmonary disease and 52 healthy individuals were collected from Shanghai Chest Hospital. Folate receptor (FR) based polymerase chain reaction (PCR) method was used to detect the circulating tumor cell (CTC) level, CEA and CYFRA21-1 was detected by the flowcytometry fluorescence luminance method, SCC was detected with Chemiluminescent microparticle immunoassay. The differences among groups were analyzed by the Kruskal-Wallis test(multi group comparison) and the Mann-Whitney U test(two group comparison), and the chi-square test was used in the positive rate comparison; the Receiver Operating Characteristics (ROC) curve was established. Results The median level of CTC in NSCLC patients was 11.90 Units/3 ml, which was significantly higher than those of benign pulmonary disease (6.72 CTC Units/3 ml) and healthy individuals (5.82 CTC Units/3 ml, χ2=125.990, P<0.01). Areas Under Curve (AUCs) of ROC curve for NSCLC was 0.853 2(95% CI: 0.809 5, 0.896 9). The cut-off value for discriminating NSCLC with benign pulmonary disease/healthy people was 8.74 CTC Units/3 ml with sensitivity being 77.16% and specificity being 90.06%.The positive rate of CTC in Stage I NSCLC patients was 68.7%, which was much higher than that of the combination of tumor markers(χ2=32.98, P<0.01). Conclusion With relatively high sensitivity and specificity, the detection of circulating tumor cell may has a clinical value of application and extension. (Chin J Lab Med, 2016, 39: 589-594) Key words: Carcinoma, non-small-cell lung; Neoplastic cells, circulating; Tumor markers, biological