Combined measurement of circulating tumor cells and magnetic nanoparticles-assisted multiple blood markers improves the diagnostic efficiency of early-stage lung adenocarcinoma

Abstract

The study aims to evaluate the efficiency and clinical value of circulating tumor cells (CTCs), blood tumor markers, and serum microRNAs for diagnosing lung adenocarcinoma in its early stages. The study included 40 patients with early-stage lung adenocarcinoma, 40 individuals with benign pulmonary nodules, and 40 healthy volunteers in groups 1, 2, and 3, respectively. The negative enrichment–fluorescence in situ hybridization was used to classify and quantify the aneuploidy and its number distribution in CTCs in groups 1–3. Magnetic nanoparticles were used to extract DNA. The levels of miR-223-3p and miR-486-5p in the serum of groups 1–3 were then determined using reverse transcription quantitative real-time polymerase chain reaction. CTC aneuploidy and its number distribution was detected and the detection of various blood markers was performed. The diagnostic accuracy was determined through receiver operating characteristic curve (ROC) drawn among the groups. The total number of CTCs and aneuploidies in patients with early-stage lung adenocarcinoma was higher than in patients with benign pulmonary nodules and healthy people. Patients with early-stage lung adenocarcinoma had significantly higher levels of miR-223-3p and miR-486-5p than patients with benign pulmonary nodules and healthy people. ROC analysis found that the sensitivity and area under the ROC curve of CTCs combined with multiple blood markers for distinguishing patients with early-stage lung adenocarcinoma from those without lung nodules were 80.12% and 0.945%, respectively. The sensitivity and area under the ROC curve of the patients were 85.38% and 0.948%, respectively. The detection of CTCs, carcinoembryonic antigen, cytokeratin 19 fragment, miR-223-3p, and miR-486-5p was effective for early-stage lung adenocarcinoma and benign lung nodules. The diagnosis of miR-223-3p is clinically significant, as the accurate diagnostic index of miR-223-3p is better than that of CTCs and other blood indicators. However, CTCs combined with blood markers have the highest efficiency in diagnosing early-stage lung adenocarcinoma.