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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

DOI https://doi.org/10.2147/CMAR.S184532

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

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