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Diagnosis of colorectal cancer based on folate receptor-positive circulating tumor cell analysis: a retrospective cohort study

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Abstract

Background

Early diagnosis and treatment are crucial to improve the prognosis of colorectal cancer (CRC). At present, there is a lack of an accurate CRC screening factor. We conducted folate receptor-positive circulating tumor cell analysis (FR + CTC analysis) in distinguishing CRC from benign colorectal diseases to evaluate the diagnostic efficiency.

Methods

Clinical data of patients admitted to The First Affiliated Hospital of Anhui Medical University from January 2021 to July 2022 were retrospectively collected. Levels of FR + CTC and other indicators were analyzed. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performance of these molecular biomarkers.

Results

Data of 103 patients with CRC and 54 patients with benign colorectal diseases were collected. FR + CTC levels were observed significantly higher in CRC patients than in patients with benign colorectal diseases (P < 0.001). FR + CTC level was correlated with tumor diameter, differentiation, T-stage, pathological stage, clinical stage, and intravascular tumor thrombus in patients with CRC (P < 0.05). The optimal cutoff value of FR + CTC level for diagnosing CRC patients was 7.66 FU/3 ml, with a sensitivity of 85.4%, a specificity of 74.1%, and an Area Under Curve (AUC) of 0.855 (95% CI 0.77–0.923). In < 50-years old patients with CRC, the diagnostic efficiency of FR + CTC was excellent, with an AUC of 0.936 (95% CI 0.877–0.995).

Conclusion

FR + CTC counting has excellent diagnostic efficiency in screening of CRC. FR + CTC count can also predict the tumor stage of CRC patients before surgery, and guide the choice of treatment.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by the Anhui Provincial Key Research and Development Project under Grant (202104j07020029);

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Authors and Affiliations

  1. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China

    Zhi-jian Wei, Bai-chuan Zhou, Wen-xiu Han, Yong-xiang Li & A-man Xu

  2. Anhui Hanhai Boxing Biotechnology Co., LTD, Hefei, 231699, Anhui, China

    Guo-xing Wang

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  1. Zhi-jian Wei
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  2. Bai-chuan Zhou
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  3. Guo-xing Wang
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  4. Wen-xiu Han
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  5. Yong-xiang Li
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  6. A-man Xu
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Contributions

B-cZ and Z-jW made the contribution to the main work equally. Conception and design: B-cZ and Z-jW. Administrative support: A-mX. Provision of study materials or patients: All authors. Collection and assembly of data: B-cZ and Z-jW. Data analysis and interpretation: B-cZ and G-xW. Manuscript writing: all authors. Final approval of manuscript: all authors.

Corresponding authors

Correspondence to Wen-xiu Han, Yong-xiang Li or A-man Xu.

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The authors report there are no competing interests to declare.

Ethics statement

Our study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University.

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Written informed consent was obtained from the authors for the publication of any potentially identifiable images or data included in our manuscript.

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Wei, Zj., Zhou, Bc., Wang, Gx. et al. Diagnosis of colorectal cancer based on folate receptor-positive circulating tumor cell analysis: a retrospective cohort study. Int J Clin Oncol 29, 149–158 (2024). https://doi.org/10.1007/s10147-023-02435-6

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  • DOI: https://doi.org/10.1007/s10147-023-02435-6

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