叶酸受体阳性循环肿瘤细胞检测在喉鳞状细胞癌诊断中的应用价值

Diagnostic utility of folate receptor-positive circulating tumor cells in patients with laryngeal squamous cell carcinoma

目的 探讨42例喉鳞状细胞癌(LSCC)患者血清中叶酸受体阳性循环肿瘤细胞(FR^(+)-CTCs)的水平及其在LSCC诊断中的应用价值。方法 检测42例LSCC患者和22例喉良性病变患者外周血中FR^(+)-CTCs水平,分析FR^(+)-CTCs与LSCC临床病理因素的关系。用受试者工作曲线(receiver operating characteristic curve,ROC)分析FR^(+)-CTCs检测在LSCC诊断中的工作效能。结果 LSCC组FR^(+)-CTCs水平高于喉良性病变组,差异具有统计学意义(t=7.269,P<0.001)。血清FR^(+)-CTCs水平与肿瘤临床分期、T分期、分化等级有关(P<0.05),与性别、年龄、部位、吸烟史、淋巴结转移无关(P>0.05)。ROC曲线显示:以9.0 FU/3 mL为血清FR^(+)-CTCs的最佳cut-off值诊断LSCC,曲线下面积(area under curve,AUC)为0.857,其敏感度为76.2%,特异度为95.5%。结论 LSCC患者外周血FR^(+)-CTCs水平较喉良性病变患者升高,且增高程度与临床分期及分化等级相关,FR^(+)-CTCs检测有望应用于LSCC的临床诊断。

Objective To determine serum levels of folate receptor-positive circulating tumor cells(FR^(+)-CTCs)in patients with laryngeal squamous cell carcinoma(LSCC)and investigate its utility in the diagnosis of LSCC.Methods Forty-two patients with LSCC and 22 with benign laryngeal lesions admitted to the authors’hospital were enrolled in this study.The significance of peripheral blood levels of FR^(+)-CTCs,combined with clinical characteristics,in the diagnosis of LSCC was analyzed.Results FR^(+)-CTC levels in patients with LSCC were higher than those in the benign group(t=7.269,P<0.001).Additionally,FR^(+)-CTC level was associated with clinical stage,T stage,and differentiation grade(P<0.05),but not with sex,age,location,smoking,or lymph node metastasis(P>0.05).The area under the receiver operating characteristic curve was 0.857;sensitivity was 76.2%and specificity was 95.5%for the detection of LSCC with 9.0 FU/3 mL as the cut-off value.Conclusion Peripheral blood levels of FR^(+)-CTCs in patients with LSCC were increased and was associated with clinical stage and differentiation grade.The determination of FR^(+)-CTC levels is anticipated to be applied in the clinical diagnosis of LSCC.