The Value Of Folate Positive Circulating Tumor Cells Combined With Tumor Markers CEA And Cyfra21-1 In The Diagnosis Of Early Non-small Cell Lung Cancer

Background:Tumor markers are the abnormal cells produced by tumor cells that lack or contain extremely small amounts of antigenic substances,which can be used for tumor screening,prognosis monitoring and therapeutic effect monitoring.Carcinoembryonic antigen(CEA)and cytokeratin 19 fragments(Cyfra21-1)are the most widely used conventional tumor markers in non-small cell Lung Cancer(NSCLC)in the diagnosis and prognosis monitoring.Circulating Tumor Cells(CTCs)in the cancer patients’peripheral blood produced by primary tumor or metastases Tumor,is the advanced means for outpatient service of screening,The Ligand targeting Polymerase Chain Reaction(LT-PCR)detection of Folate Receptor of Circulating Tumor Cells(FRs+-CTCs)is the highest sensitivity and specificity of Circulating Tumor Cells.The purpose of this study was to investigate the role of serum tumor markers CEA and cyfra21-1 combined with LT-PCR detection of FRs+-CTCs in the diagnosis of early NSCLC.Methods:From 2018 to 2019,153 patients with lung cancer,25 patients with lung benign diseases and 20 healthy donor who were admitted to our hospital were reviewed.Peripheral blood result of CEA,CYFRA21-1and FR﹢-CTCs were collected.The diagnostic value of each marker was analyzed using receiver operating characteristic(ROC)curves.and SPSS 22.0.Results:The positive rate of FR+-CTCs in the NSCLC group(75.3%)was significantly higher than the positive rate in both healthy control group(5%)and the lung benign lesion group(8%)(c~2=13.632 P=0.001).The diameter and stage of the tumor were the main factors affecting the expression of FR+-CTCs in the NSCLC group(c~2=13.632P=0.001;H=9.924,P<0.01),independent from the patient’s age,gender,and smoking history(Z=0.545,P=0.178.Z=0.519,P=0.917;Z=0.844,P=0.412).In NSCLC group,thecombinedtestingofCEA、CYFRA21-1and FRs+-CTCs(AUCCEA+CYFRA21-1+FR+-CTCs=0.778(95%CI 0.720-0.816),diagnostic sensitivity is 77.50%,specificity is 78.08%)contributed higher diagnostic value than the combined testing of CEA and CYFRA21-1(AUCCEA+CYFRA21=0.707(95%CI 0.660-0.756),diagnostic sensitivity is 66.53%,specificity is 71.95%).Conclusion:The FR+-CTCs combined with the tumor marker CEA,cyfra21-1 can improve the sensitivity and the specificictyin the diagnosis of NSCLC..