Clinical Value of Folate-Receptor Positive Circulating Tumor Cell in Diagnosing Papillary Thyroid Cancer: A Retrospective Study

Abstract

Abstract Backgrounds: Folate receptor-positive circulating tumor cells (FR+CTCs) have been proven effective in cancer diagnosis; this study aims to investigate the clinical significance of FR+CTC in diagnosing papillary thyroid cancer (PTC) patients. Methods: This retrospective study enrolled 1129 patients. Ligand-targeted polymerase chain reaction (LT-PCR) was utilized to detect FR+CTC. Variables with statistical significance were selected to draw the ROC curves, and accordingly, sensitivity, specificity, and AUC were calculated for comparison. The clinical data were used to construct univariate and multivariate logistic regression models. A predicting model was established, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: 846 patients were finally included, of which 433 were clustered into the benign group and 413 were categorized into the papillary thyroid cancer (PTC) group. There were significant differences between FR+CTC, TSH, TT3, FT3, Tg, TgAb, and Age of the two groups (P＜0.05). The AUCs of the above seven risk factors were 0.690 (95% CI, 0.654-0.725), 0.632 (95% CI, 0.594-0.669), 0.567 (95% CI, 0.528-0.606), 0.585 (95% CI, 0.547-0.623), 0.735 (95% CI, 0.701-0.769), 0.588 (95% CI, 0.549-0.626) and 0.646 (95% CI, 0.609-0.683), respectively. The AUC of the combined model was 0.815 (95% CI, 0.785-0.844). The univariate and multivariate analysis identified age (OR, 0.41; 95% CI: 0.29-0.57), FR+CTC (OR, 3.7; 95% CI: 2.65–5.22), TSH (OR, 3.18; 95% CI: 2.22-4.59) and Tg (OR, 0.25; 95% CI: 0.18-0.35) as independent predictors. Conclusions: FR+CTCs is a potential biomarker to distinguish PTC and is correlated with tumor location, ATA risk stratification (between high risk and low risk group), and N stage. Trial registration: Not applicable.