Application value of folate receptor-positive circulating tumor cells in auxiliary diagnosis and therapeutic effect monitoring of ovarian cancer

Objective To investigate the clinical application value of folate receptor-positive circulating tumor cells (FFR⁺-CTC) in the auxiliary diagnosis and curative effect monitoring of ovarian cancer.

Methods Thirty-one patients with ovarian cancer were retrospectively selected as ovarian cancer group, and 59 healthy individuals were included in control group. The peripheral blood FR⁺-CTC contents of the two groups were compared, and the FR⁺-CTC detection results of ovarian cancer patients with different clinical characteristics were observed. The diagnosis of ovarian cancer by FR⁺-CTC, serum tumor markers including carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) were compared, and the staging of FR⁺-CTC and CA125 positive ovarian cancer patients were analyzed.

Results There were no significant differences in the positive rate of FR⁺-CTC among ovarian cancer patients with different ages, different stages, different tissue types and with or without distant metastasis (P>0.05). The levels of FR⁺-CTC in peripheral blood of patients in the ovarian cancer group before and after treatment were higher than those in the control group (P < 0.05). After treatment, the level of FR⁺-CTC in peripheral blood of the ovarian cancer group was lower than before treatment, but the difference was not statistically significant (P>0.05). The sensitivity of peripheral blood FR⁺-CTC in the diagnosis of ovarian cancer was 87.10%, which was higher than 63.16% by CA125 and 52.38% by HE4, respectively, and the differences were statistically significant (χ²=3.934, 7.669, P=0.047, 0.006). FR⁺-CTC can be used as an early independent predictor of ovarian cancer. The results of Pearson correlation analysis showed that there were no correlations of FR⁺-CTC with CA125 and HE4 (r=0.280, 0.384, P>0.05). Among the patients with FR⁺-CTC positive ovarian cancer, patients in stages of Ⅲ to Ⅳ accounted for 70.37%, which was higher than 29.63% in those in stages of Ⅰ to Ⅱ, and the differences were statistically significant (P < 0.05). In CA125 positive ovarian cancer patients, the proportion of patients in stages of Ⅲ to Ⅳ was 91.67%, which was higher than 8.33% of those in stages ofⅠtoⅡ, and the difference was statistically significant (P < 0.05).

Conclusion The content of FR⁺-CTC in peripheral blood of patients with ovarian cancer is significantly higher than healthy people, and the content of FR⁺-CTC in peripheral blood decreases after treatment, and diagnostic efficacy of FR⁺-CTC is better in diagnosis of stages of Ⅰ to Ⅱovarian cancer than CA125, suggesting that peripheral blood FR⁺-CTC can be used for early diagnosis and curative effect monitoring of ovarian cancer.