AUTHOR=Wan Lingling , Liu Qingyi , Liang Di , Guo Yongdong , Liu Guangjie , Ren Jinxia , He Yutong , Shan Baoen 

TITLE=Circulating Tumor Cell and Metabolites as Novel Biomarkers for Early-Stage Lung Cancer Diagnosis

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.630672

DOI=10.3389/fonc.2021.630672

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Lung cancer is a malignant tumor that has the highest morbidity and mortality rate among all cancers. Early diagnosis of lung cancer is a key factor in reducing mortality and improving prognosis.</p></sec><sec><title>Methods</title><p>In this study, we performed CTC next-generation sequencing (NGS) in early-stage lung cancer patients to identify lung cancer-related gene mutations. Meanwhile, a serum liquid chromatography-tandem mass spectrometry (LC-MS) untargeted metabolomics analysis was performed in the CTC-positive patients. To screen potential diagnostic markers for early lung cancer.</p></sec><sec><title>Results</title><p>62.5% (30/48) of lung cancer patients had ≥1 CTC. By CTC NGS, we found that &gt; 50% of patients had 4 commonly mutated genes, namely, <italic>NOTCH1</italic>, <italic>IGF2</italic>, <italic>EGFR</italic>, and <italic>PTCH1</italic>. 47.37% (9/19) patients had <italic>ARIDH1</italic> mutations. Additionally, 30 CTC-positive patients and 30 healthy volunteers were subjected to LC-MS untargeted metabolomics analysis. We found 100 different metabolites, and 10 different metabolites were identified through analysis, which may have potential clinical application value in the diagnosis of CTC-positive early-stage lung cancer (AUC &gt;0.9).</p></sec><sec><title>Conclusions</title><p>Our results indicate that NGS of CTC and metabolomics may provide new tumor markers for the early diagnosis of lung cancer.</p></sec>