The utility of folate receptor-positive circulating tumor cell in cancer diagnosis in the elderly population
Authors Li N, Zhong D, Chen H, Huang T, Hou P, Zhang Y, Chen F, Wang X, Zhang H
Received 19 August 2018
Accepted for publication 7 March 2019
Published 6 May 2019 Volume 2019:11 Pages 4097—4107
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Andrew Yee
Peer reviewer comments 3
Editor who approved publication: Dr Rituraj Purohit
Na Li,1 Dingrong Zhong,2 Huang Chen,2 Tiequn Huang,1 Pihua Hou,1 Yinan Zhang,3 Fangling Chen,3 Xiaoping Wang,1 Hongchun Zhang1
1Department of Medical Health Care; 2Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, People’s Republic of China; 3Graduate School, Beijing University of Chinese Medicine, Beijing 100029, People’s Republic of China
Purpose: Cancer mortality is relatively high in the elderly population. Folate receptor-positive circulating tumor cell (FR+CTC) has proven an effective biomarker for diagnosis of lung cancer and bladder cancer and may be suitable for other cancer types accompanied with a high expression of FR. To date, the diagnostic efficiency of FR+CTC in the elderly population has not been systematically studied. Herein, we sought to investigate the utility of FR+CTC in cancer diagnosis in the elderly population and the influence of comorbidities on FR+CTC levels in such a population.
Patients and methods: A total of 35 cancer patients (including 23 lung cancers, 8 colorectal cancers, and 4 other cancers) and 40 noncancer participants, aged between 80 and 110, were recruited in this study. Three milliliters of pretreatment peripheral blood was collected from each participant for FR+CTC analysis.
Results: Compared to previous studies, the FR+CTC level was slightly higher in the elderly population (median FR+CTC levels in cancer patients versus noncancer participants were 14.3 versus 9.2 CTC U/3 mL, respectively, P=0.0002). With 10.0 CTC U/3 mL as the cut-off value, the sensitivity and specificity of FR+CTC were 85.7% and 65.0%, respectively. In combination with established serum tumor biomarkers, the diagnostic efficiency of FR+CTC further improved (sensitivity=87.9%, specificity=71.8%). Clinical factors including diabetes, cardiovascular diseases, respiratory diseases, cerebral infarction, and cardiac, liver, and kidney function were not associated with the FR+CTC level (P>0.05).
Conclusion: In this exploratory study, we showed that FR+CTC is an effective biomarker for cancer diagnosis in the elderly population. The presence of comorbidities did not affect the diagnostic efficiency of FR+CTC.
Keywords: biomarker, cancer, circulating tumor cell, elderly, folate receptor
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]