Evaluation of sensitivity and specificity of CanPatrol™ technology for detection of circulating tumor cells in patients with non-small cell lung cancer

Abstract

Background The early diagnosis of non-small cell lung cancer is of great significance to the prognosis of patients. However, traditional histopathology and imaging screening have certain limitations. Therefore, new diagnostical methods are urgently needed for the current clinical diagnosis. In this study we evaluated the sensitivity and specificity of CanPatrol™ technology for the detection of circulating tumor cells in patients with non-small cell lung cancer (NSCLC). Methods CTCs in the peripheral blood of 98 patients with NSCLC and 38 patients with benign pulmonary diseases were collected by the latest typing of CanPatrol™ detection technology. A 3-year follow-up was performed to observe their recurrence and metastasis. Kruskal-Wallis test was used to compare multiple groups of data, Mann-Whitney U test was used to compare data between the two groups, and ROC curve analysis was used to obtain the critical value. The COX risk regression and Kaplan-Meier survival analysis were performed in the 63 NSCLC patients who were effectively followed up. Results The epithelial, epithelial-mesenchymal, and total CTCs were significantly higher in NSCLC patients than that in patients with benign lung disease (P < 0.001). The mesenchymal CTCs of NSCLC patients was slightly higher than that of benign lung diseases (P = 0.013). The AUC of the ROC curve of the total CTCs was 0.837 (95% CI: 0.76-0.914), and the cut-off value corresponding to the most approximate index was 0.5 CTCs/5 ml, at which point the sensitivity was 81.6% and the specificity was 86.8%. COX regression analysis revealed that the clinical stage was correlated with patient survival (P = 0.006), while gender, age, and smoking were not (P > 0.05). After excluding the confounders of staging, surgery, and chemotherapy, Kaplan-Meier survival analysis showed that patients in stage IIIA with CTCs ≥0.5 had significantly lower DFS than those with CTCs < 0.5 (P = 0.022). Conclusions CTC positive can well predict the recurrence of NSCLC patients. CanPatrol™ technology has good sensitivity and specificity in detecting CTCs in peripheral blood of NSCLC patients and has a certain value for clinical prognosis evaluation.

Circulating tumor cells with epithelial-mesenchymal transition markers as potential biomarkers for the diagnosis of lung cancer

“…The expression of these markers allows the classification of CTCs into different subtypes, namely, E-CTCs, M-CTCs, and E&M-CTCs[ 12 ]. A recent study[ 18 ] reported that the sensitivity and specificity of total CTCs detected by CanPatrol™ technology for the diagnosis of LC is 81.6% and 86.8%, respectively, which is consistent with the present results.…”

Correlation Between Circulating Tumor Cell DNA Genomic Alterations and Mesenchymal CTCs or CTC-Associated White Blood Cell Clusters in Hepatocellular Carcinoma

“…The different characteristics of tumor tissue DNA and CTC-DNA may be due to the temporal and spatial heterogeneity of tumors. Although many studies have confirmed the feasibility of capturing CTC based on the Canpatrol ™ platform (13,14), we still cannot rule out that technical reasons cause this difference to be affected by the analyzed tumor percentage. The method of capturing CTCs to extract DNA and sequencing can compensate for the deficiency of tumor tissue DNA.…”

“…We collected 7.5 ml of peripheral venous blood from the patient, and the CanPatrol ™ CTC analysis system (SurExam, China) was used to capture and enrich CTC. RNA-ISH was used to label various CTC subtypes (13,14). Epithelial cells are positive for EpCAM and CK8/18/19 (red fluorescence); mesenchymal cells are positive for vimentin/twist (green fluorescence), and mixed cells show red fluorescence and green fluorescence.…”

Research progress on circulating tumor cells of hepatocellular carcinoma

“…After incubation, the cells expressing epithelial cell markers + , DAPI + , and CD45 − are considered epithelial CTCs, cells expressing mesenchymal cell markers + , DAPI + , and CD45 − are considered mesenchymal CTCs, and those expressing epithelial cell markers + , mesenchymal cell markers + , DAPI + , and CD45 − are considered mixed CTCs. 9 …”