Clinical value of CTCs combined with serum tumor markers/inflammatory cytokines for the early diagnosis of non-small cell lung cancer.

OBJECTIVE

This study investigates the clinical utility of circulating tumor cells (CTCs) in combination with serum tumor markers/inflammatory cytokines for the diagnosis of early-stage non-small cell lung cancer (NSCLC).

METHODS

A retrospective analysis was conducted on the clinical data of 43 NSCLC patients (stage I-IIA) who underwent surgical treatment at the Fourth Hospital of Hebei Medical University between November 2021 and December 2022. A control group of 50 healthy individuals was also included. Comparative analyses of CTCs, serum tumor markers, and inflammatory cytokine levels were performed between the two groups. The clinical diagnostic value was assessed using receiver operating characteristic (ROC) curve analysis.

RESULTS

The median concentrations of CTCs, carcinoembryonic antigen (CEA), Cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), and interleukin-17 A (IL-17 A) were significantly elevated in the NSCLC cohort compared to the healthy control cohort, while interleukin-2 (IL-2) levels were reduced (P < 0.05). ROC curve analysis revealed that CTCs exhibited a sensitivity of 65.12%, specificity of 100.00%, and an area under the curve (AUC) of 0.826 for the diagnosis of early-stage NSCLC. The combined diagnostic sensitivity of CTCs, CEA, CYFRA21-1, and NSE reached 86.05%, with 100.00% specificity and an AUC of 0.945. Among the seven inflammatory cytokines evaluated, IL-17 A exhibited the highest diagnostic efficacy for early-stage NSCLC, with an AUC of 0.871, sensitivity of 93.02%, and specificity of 75.00%. The combination of IL-17 A and CTCs achieved an AUC of 0.953, with a sensitivity of 86.05% and specificity of 90.00%.

CONCLUSION

The integration of CTCs with serum tumor markers and/or inflammatory cytokines provides high sensitivity and specificity for the diagnosis of early-stage NSCLC, highlighting its significant clinical potential.