title: [Diagnostic Value of Folate Receptor-positive Circulating Tumor Cell in Lung Cancer: A Pilot Study].
abstract: BACKGROUND
  The aim of this study is to determine the efficacy and feasibility of a novel folate receptor (FR)-based circulating tumor cell (CTC) detection method in the diagnosis of lung cancer. CTCs were collected from 3 mL of blood based on negative enrichment by immunomagnetic beads and then labeled by a conjugate of a tumor-specific ligand folate and an oligonucleotide.
  
  
  METHODS
  After washing off redundant conjugates, the bound conjugates were removed and analyzed by quantitative polymerase chain reaction.
  
  
  RESULTS
  The CTC levels of 97 patients with lung cancer were significantly higher than that of the controls (18 patients with benign lung diseases; P<0.001). With a threshold of 8.7 Folate units, the method showed a sensitivity of 82.5% and a specificity of 72.2% in the diagnosis of lung cancer, especially a sensitivity of 86.8% in stage I disease. Compared with the existing clinical biomarkers such as neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), and CYFRA21-1, the method showed the highest diagnostic efficiency in lung cancer (area under the curve, 0.859; 95%CI: 0.779-0.939) and stage I lung cancer (area under the curve, 0.912; 95%CI: 0.829-0.994). For future work, the CTC levels of 5 lung cancer patients higher than 8.7 Folate units/3 mL in their postoperation.
  
  
  CONCLUSIONS
  FR-positive CTCs were feasible diagnostic biomarkers in patients with lung cancer, as well as in early-stage tumors.
authors.affiliation: Department of Thoracic Surgery, Henan Oncology Hospital, Zhengzhou 450008, China.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Lian
authors.affiliation: Department of Thoracic Surgery, Henan Oncology Hospital, Zhengzhou 450008, China.
authors.forename: Zhidan
authors.initials: Z
authors.lastname: Ding
authors.affiliation: Department of Thoracic Surgery, Henan Oncology Hospital, Zhengzhou 450008, China.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Yuan
authors.affiliation: Department of Molecular Pathology Center, Henan Oncology Hospital, Zhengzhou 450008, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Thoracic Surgery, Henan Oncology Hospital, Zhengzhou 450008, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Qin
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D058973:Folate Receptors, GPI-Anchored / Q000097:blood* / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism* / Q000473:pathology; D010865:Pilot Projects
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D058973:Folate Receptors, GPI-Anchored