Abstract
Folate-receptor positive circulating tumor cells (FR+CTCs) shows an important role in the diagnosis and dynamic monitoring for many solid tumors; however, the application of FR+CTCs in prostate cancer remains unclear. We explored the potential application of FR+CTCs in this retrospective study. The levels of FR+CTCs were detected in 30 prostate cancer patients and 7 bladder cancer patients in Peking University Cancer Hospital from August 2017 to August 2021. Clinical and pathology data were collected. One-way ANOVA was used to compare the difference in FR+CTCs levels in patients with prostate cancer, bladder cancer, and benign disease. The area under the receiver operating curve (AUROC) was used to compare the accuracy of FR+CTCs and tPSA in the diagnosis of prostate cancer. We found that levels of FR+CTCs were significantly higher in cancer patients (both prostate and bladder cancer) than in patients with benign urinary disease (p < 0.001). Besides, FR+CTCs level was consistently high in the prostate cancer patients with different tPSA levels (p < 0.001), and it was significantly higher in the patients with f/tPSA levels <0.16 than in those patients with f/tPSA levels >0.16 (12.20 ± 1.31 vs. 8.73 ± 0.92 FU/3 ml, p = 0.043). The diagnosis efficiency of FR+CTCs is better than the tPSA in prostate cancer patients with tPSA <10 ng/ml (0.871 vs. 0.857). In the prostate cancer patients with tPSA <10 ng/ml and f/tPSA <0.16, a combination of FR+CTCs and tPSA (AUROC, 0.934) further increased the diagnosis efficiency of each of these biomarkers alone (FR+CTCs, 0.912; tPSA, 0.857). Therefore, FR+CTCs could serve as an early diagnosis marker in the prostate cancer patients with uncertain tPSA levels.
Highlights
Prostate cancer is the second common male malignant in the global
We enrolled the patients into prostate cancer group following these rules: the patients have been suspected of prostate cancer with elevated tPSA or clinical manifestation; the Folate-receptor positive circulating tumor cells (FR+CTCs) detection should be taken before the TRUS-Bx biopsy; and the date of tPSA and f/tPSA examination should be closer to the date of the folate receptor (FR)+CTCs detections (± 2 days)
To evaluate the potential applications of FR+CTCs in the urinary tract cancers, we retrospectively collected the clinical data from 37 malignant patients and 7 benign disease patients
Summary
Prostate cancer is the second common male malignant in the global. The incidence of prostate cancers in China is consistently increasing in recent years. The patients whose serum tPSA level >4.0 ng/ml should be subject to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) [1]. The positive ratio of initial TRUS-Bx for the men with elevated tPSA is only 40–45% [2, 3]. A systematic meta-analysis of prostate cancer in China indicated that the sensitivity and specificity threshold of tPSA for prostate cancers candidates were heterogeneous depending on the level of tPSA [4]. TPSA alone, especially when tPSA
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