Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

The Role of Circulating Tumor Cell as a Promising Biomarker in the Evaluation of Pulmonary Nodules: A Prospective Study: Shijie Wang, Changdan Xu, Xiaohong Xu, Weipeng Shao, Guohui Wang, Xiongtao Yang, Liwei Gao, Feng Teng, Hongliang Sun, Yue Zhao, Hongxiang Feng, Guangying Zhu; Cancer Res Treat. 2026;58(1):128-140. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.841

Abstract PDF Supplementary Material PubReader ePub

Purpose
Our previous study showed that circulating tumor cell (CTC) count combined with gene mutation detection might help differentiate benign and malignant pulmonary nodules (PNs). Herein, we aimed to expand the study cohort and conduct further sequencing analysis.
Materials and Methods
Patients with PNs were included, and CTCs were identified before operation. Low-coverage whole-genome sequencing (LC-WGS) and lung cancer-related targeted gene sequencing were performed on CTCs. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve. The differences in CTC counts among subgroups classified by demographic–clinical characteristics were analyzed. LC-WGS–based copy number variation (CNV) analysis and targeted gene mutation analysis were conducted.
Results
A total of 172 patients were included. CTC count of 2.5 was identified by the ROC curves as the optimal diagnostic cutoff. The sensitivity and specificity of CTC count for differentiating benign and malignant PNs were 54.2% and 78.6%, respectively. The diagnostic sensitivity and specificity of combined CTC count, radiological nodule type, and any malignant imaging features were 84.7% and 71.4%, respectively. The CTC counts were significantly greater in patients with aggressive tumors, later stage, and spread through air spaces. CTCs from malignant cases had more CNVs than those from benign cases.
Conclusion
CTC count can be used in identifying malignant PNs. The diagnostic efficacy can be improved if combined with computed tomography imaging characteristics. Further CNV analysis might help differential diagnosis. Greater CTC count might suggest more aggressive tumors. CTC detection can provide important information and guidance for subsequent management of PNs.

Citations

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Integrated CT Radiomics and Circulating Tumor Cell Analysis in Predicting Lung Adenocarcinoma Invasion: A Dual-Center Study with Implications for Personalized Treatment
Qingtao Zhao, Runzhe Wang, Qingxin Zhao, Dahu Ren, Lingxin Kong, Xiaopeng Zhang, Guochen Duan
OncoTargets and Therapy.2026; Volume 19: 1. CrossRef

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Clinical Study of Stage I Renal Cell Carcinoma: Heeyoul Kim, Won Hee Woo, Duk Kyo Kim, Sei Kyung Rho, Sun Ju Lee, Sung Goo Chang; J Korean Cancer Assoc. 1997;29(6):1100-1105.

Abstract PDF: PURPOSE
This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy.
MATERIALS AND METHODS
Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy.
RESULTS
Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor.
CONCLUSIONS
These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.

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