Study on the clinical application value of a new type of magnetic nanomicrospheres that can be used for circulating tumor cell sorting in lung cancer

s Purpose The high incidence and mortality rates of lung cancer pose a great challenge for early detection and prognostic assessment. Liquid biopsy biomarkers based on circulating tumor cells (CTC) and circulating tumor DNA (ctDNA), among others, hold promise for non-invasive detection. The aim of this study was to construct a CTC sorting system that can be used to monitor lung cancer progression and compared with ctDNA for downstream analysis. Results The sorting efficiency of the CTC sorting system for lung cancer cells was 95.70 %, and the system demonstrated the ability to monitor CTC changes and tumor progression in animals. The cutoff value of CTC detection in lung cancer was 7.5/5 mL (Area under the curve [AUC]: 0.9976, 95 % CI: 0.9946–1.000), with a sensitivity of 96.70 % and specificity of 98.41 %, effectively indicating progression. Compared with ctDNA, CTC-based analysis detected a broader genomic mutation spectrum with a concordance rate of 19.90 %, but the detection rate of the genomic mutation spectrum could be expanded by the combined test. Conclusion In this study, we successfully developed a novel clinically feasible CTC sorting system capable of monitoring lung cancer progression, which can be applied to early diagnosis, efficacy assessment, and monitoring tumor progression in lung cancer. In addition, CTC showed low concordance with mutations found in ctDNA, and CTC may have specific mutations independent of ctDNA.