Prognostic Value of Folate Receptor-positive Circulating Tumor Cells in Patients with Radical Resection of Colorectal Cancer
ZHANG Rixiong
WU Zuguang
LIU Fan
CHEN Wenju
LIU Hongtao
RAO Hui
LI Yunlin
Abstract：Objective To analyze the prognostic value of folate receptor-positive circulating tumor cells(FR+-CTCs)in colorectal cancer(CRC)patients undergoing radical resection.Methods A retrospective analysis was conducted on 142 CRC patients who underwent radical resection at Meizhou People's Hospital from March 2021 to October 2022.The patients were classified into a disease-free group(n=98)and a progression group(n=44).General clinical data and preoperative FR+-CTCs levels were compared between groups.Cox regression analysis was used to identify independent risk factors affecting CRC prognosis,and a nomogram prediction model was constructed.The model's value was assessed.Based on the optimal cut-off value of preoperative FR+-CTCs levels,the 142 patients were divided into a high-level group(n=52)and a low-level group(n=90).Disease-free survival(DFS)was compared between these groups.Results Age,maximum tumor diameter,preoperative FR+-CTCs levels,proportion of Dukes C1 stage,and proportion of poor differentiation were significantly higher in the progression group than in the disease-free group(P<0.05).Multivariate Cox regression showed that age,maximum tumor diameter,Dukes stage,differentiation degree,and preoperative FR+-CTCs level were independent risk factors for CRC prognosis(P<0.05).The constructed nomogram model had an area under the curve(AUC)of 0.95 in both the training and validation sets.Hosmer-Lemeshow goodness-of-fit test showed χ2=3.164(P=0.924)for the validation set.Decision curve analysis indicated better clinical net benefit when the validation set threshold probability was 0.02-0.96.At follow-up until November 2024,the high-level group had significantly shorter DFS than the low-level group(P<0.05).Conclusion FR+-CTCs is an independent risk factor affecting CRC prognosis.The nomogram combining FR+-CTCs with traditional clinicopathological factors provides a practical tool for DFS prediction,which is expected to optimize individualized treatment strategies for CRC.
Keywords：Folate receptor-positive circulating tumor cellsRadical resection for colorectal cancerPrognosisnomogramDisease-free survival
Publication Date：2025-07-20
Online Publishing Date：2025-08-27(First online date of this platform, not the publication date of the document)
Pages：6( 95-100 )