Dataset Information

The development and validation of a circulating tumor cells-based integrated model for improving the indeterminate lung solid nodules diagnosis.

ABSTRACT:

Background

There is a risk of over investigation and delayed treatment in the work up of solid nodules. Thus, the aim of our study was to develop and validate an integrated model that estimates the malignant risk for indeterminate pulmonary solid nodules (IPSNs).

Methods

Patients included in this study with IPSNs who was diagnosed malignant or benign by histopathology. Univariate and multivariate logistic regression were used to build integrated model based on clinical, circulating tumor cells (CTCs) and radiomics features. The performance of the integrated model was estimated by applying receiver operating characteristic (ROC) analysis, and tested in different nodules size and intermediate risk IPSNs. Net reclassification index (NRI) was applied to quantify the additional benefit derived from the integrated model.

Results

The integrated model yielded areas under the ROC curves (AUCs) of 0.83 and 0.76 in internal and external set, respectively, outperforming CTCs (0.70, P=0.001; 0.68, P=0.128), the Mayo clinical model (0.68, P<0.001; 0.55, P=0.007), the and radiomics model (0.72, P=0.002; 0.67, P=0.050) in both validation sets. Robust performance with high sensitivity up to 98% was also maintained in IPSNs with different solid size and intermediate risk probability. The performance of the integrated model was comparable with positron emission tomography/computed tomography (PET-CT) examination (P=0.308) among the participants with established PET-CT records. NRI demonstrated that the integrated model provided net reclassification of at least 10% on the external validation set compared with single CTCs test.

Conclusions

The integrated model could complement conventional risk models to improve the diagnosis of IPSNs, which is not inferior to PET-CT and could help to guide clinician's decision-making on clinically specific population.

SUBMITTER: Wan Z

PROVIDER: S-EPMC10087991 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

The development and validation of a circulating tumor cells-based integrated model for improving the indeterminate lung solid nodules diagnosis.

Wan Ziwei Z He Hua H Zhao Mengmeng M Ma Xiang X Sun Shuo S Wang Tingting T Deng Jiajun J Zhong Yifan Y She Yunlang Y Ma Minjie M Wang Haifeng H Chen Qiankun Q Chen Chang C

Translational lung cancer research 20230328 3

<h4>Background</h4>There is a risk of over investigation and delayed treatment in the work up of solid nodules. Thus, the aim of our study was to develop and validate an integrated model that estimates the malignant risk for indeterminate pulmonary solid nodules (IPSNs).<h4>Methods</h4>Patients included in this study with IPSNs who was diagnosed malignant or benign by histopathology. Univariate and multivariate logistic regression were used to build integrated model based on clinical, circulatin ...[more]

PMID: 37057115

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Project description:BackgroundLung cancer has become the most common malignant tumor worldwide, with the highest rates of morbidity and mortality. The detection of circulating tumor cells (CTCs) can be simple, rapid, and minimally invasive, thus endowing them with a high value in the diagnosis of malignant tumors. We aimed to explore the correlation between CTCs in peripheral blood and benign or malignant solitary pulmonary nodules (SPNs).MethodsA total of 223 patients with SPNs from January 2018 to May 2020 were recruited. During the same period, 20 healthy volunteers were recruited as controls. Venous blood samples were collected from participants for detecting CTCs using a folate receptor (FR)-positive cell detection kit, as well as tumor biomarkers.ResultsA significant difference in the level of CTCs were observed between the malignant SPNs group, the benign SPNs group, and the control group, which was markedly higher in the malignant SPNs group (10.48±3.49 FU/3 mL) than both the benign SPNs and control groups (6.38±0.53 and 4.45±1.21 FU/3 mL, respectively) (P<0.001). In addition, the level of CTCs was significantly higher in the benign SPNs group than in the control group (P=0.023). In particular, in the malignant SPNs group, patients older than 60 years (11.45±3.92 FU/3 mL) presented a notably higher level of CTCs than other patients (9.55±2.74 FU/3 mL). The patients were then classified according to the pathological subtypes of lung cancer. There was a significant difference in level of CTCs among patients with squamous cell carcinoma (9.10±1.94 FU/3 mL), adenocarcinoma (10.77±3.71 FU/3 mL), and adenosquamous cell carcinoma (11.78±2.61 FU/3 mL). Binary logistic regression analysis suggested that CTCs were an independent risk factor of malignant SPN (OR =3.698, 95% CI: 1.136-11.035, P=0.030). The sensitivity and specificity of CTCs in diagnosing malignant SPNs was significantly higher than tumor biomarkers (single or combined) [sensitivity =89.1%; specificity =92.3%; area under curve (AUC) (95% CI) =0.907 (0.861-0.942)].ConclusionsPeripheral blood CTCs can be used in the diagnosis of malignant SPNs and are recommended for clinical application.

Dataset Information

The development and validation of a circulating tumor cells-based integrated model for improving the indeterminate lung solid nodules diagnosis.

Background

Methods

Results

Conclusions

Publications

The development and validation of a circulating tumor cells-based integrated model for improving the indeterminate lung solid nodules diagnosis.

Similar Datasets

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