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Precision patient selection for improved detection of circulating genetically abnormal cells in pulmonary nodules
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Precision patient selection for improved detection of circulating genetically abnormal cells in pulmonary nodules
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Journal Article
Precision patient selection for improved detection of circulating genetically abnormal cells in pulmonary nodules
2024
Overview
Circulating genetically abnormal cells (CACs) have emerged as a promising biomarker for the early diagnosis of lung cancer, particularly in patients with pulmonary nodules. However, their performance may be suboptimal in certain patient populations. This study aimed to refine patient selection to improve the detection of CACs in pulmonary nodules. A retrospective analysis was conducted on 241 patients with pulmonary nodules who had undergone pathological diagnosis through surgical tissue specimens. Utilizing consensus clustering analysis, the patients were categorized into three distinct clusters. Cluster 1 was characterized by older age, larger nodule size, and a higher prevalence of hypertension and diabetes. Notably, the diagnostic efficacy of CACs in Cluster 1 surpassed that of the overall patient population (AUC: 0.855 vs. 0.689,
P
= 0.044). Moreover, for Cluster 1, an integrated diagnostic model was developed, incorporating CACs, sex, maximum nodule type, and maximum nodule size, resulting in a further improved AUC of 0.925 (95% CI 0.846–1.000). In conclusion, our study demonstrates that CACs detection shows better diagnostic performance in aiding the differentiation between benign and malignant nodules in older patients with larger pulmonary nodules and comorbidities such as diabetes and hypertension. Further research and validation are needed to explore how to better integrate CACs detection into clinical practice.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ Adult
/ Aged
/ Biomarkers, Tumor - genetics
/ Circulating genetically abnormal cells
/ Diabetes
/ Early Detection of Cancer - methods
/ Female
/ Humanities and Social Sciences
/ Humans
/ Male
/ Multiple Pulmonary Nodules - blood
/ Multiple Pulmonary Nodules - diagnosis
/ Multiple Pulmonary Nodules - genetics
/ Multiple Pulmonary Nodules - pathology
/ Neoplastic Cells, Circulating - metabolism
/ Neoplastic Cells, Circulating - pathology
/ Patients
/ Science
/ Solitary Pulmonary Nodule - blood
/ Solitary Pulmonary Nodule - diagnosis
