Folate receptor-positive circulating tumor cells as a potential biomarker for breast cancer diagnosis

Abstract

This study investigated the potential of folate receptor-positive circulating tumor cells (FR+CTCs) as a non-invasive biomarker for breast cancer diagnosis and clinical stratification. Between January 2024 and October 2024, 179 breast cancer patients and 38 patients with benign breast diseases were enrolled at Sichuan Provincial People’s Hospital, China. FR+CTCs were isolated from peripheral blood using the CytoploRare® kit and quantified via real-time polymerase chain reaction. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. FR+CTC levels were significantly higher in breast cancer patients compared to those with benign diseases ( P <0.001). The ROC analysis yielded an area under the curve of 0.871 (95% confidence interval: 0.818– 0.924), with a sensitivity of 82.12% and specificity of 84.21%. In addition, FR+CTC levels correlated significantly with T, N, M, and tumor node metastasis stages, as well as molecular subtypes, particularly human epidermal growth factor receptor-2 ( P <0.05). FR+CTCs demonstrate significant potential as a non-invasive biomarker for breast cancer, showing high diagnostic accuracy and associations with key clinical characteristics. While promising, these findings warrant validation in larger, more diverse populations.