A New Model Based on Folate Receptor-Positive Circulating Tumor Cells - for the Preoperative Prediction of Peritoneal Metastasis in Gastrointestinal Malignancies - A Retrospective Study in China

Q: How were risk factors and predictive performance evaluated?

Risk factors were identified using logistic regression, ROC curves were generated with the pROC package in R, and Spearman correlation was used to assess relationships between FR+-CTC counts and risk factors. Predictive capacity was validated using 10-fold cross-validation.

Q: Which variables were identified as risk factors for peritoneal metastasis?

FR+-CTC count, albumin level, total protein level, and cancer antigen 125 (CA-125) level.

Sep 23, 2026

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A retrospective study constructs and evaluates a new predictive model using folate receptor-positive circulating tumor cells (FR+-CTC) to estimate preoperative peritoneal metastasis risk in gastrointestinal malignancies. Patients with preoperative FR+-CTC counts were collected and peritoneal metastasis risk factors were identified via logistic regression, assessed with ROC analysis and Spearman correlation. The model links FR+-CTC quantity with albumin, total protein, and CA-125, and shows stable performance through 10-fold cross-validation, supporting preoperative clinical assessment.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Article Info

Background/Aims

Methods

Results

Conclusions

Key Words

Gut and Liver [https://doi.org/10.5009/gnl240462](https://doi.org/10.5009/gnl240462)[ ](https://doi.org/10.5009/gnl240462)[pISSN 1976-2283 eISSN 2005-1212](pISSN 1976-2283 eISSN 2005-1212) Original Article | A New Model Based on Folate Receptor-Positive Circulating Tumor Cells for the Preoperative Prediction of Peritoneal Metastasis in Gastrointestinal Malignancies: A Retrospective Study in China
Dan Li1,2 , Can Liu3 , Renwang Hu1,2
1Department of Gastrointestinal Surgery, Henan Provincial People's Hospital, Zhengzhou, China; 2Department of Gastrointestinal Surgery, Zhengzhou University People’s Hospital, Zhengzhou, China; 3Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China | | | | --- | --- | --- | | Article Info
Received October 9, 2024
Revised November 28, 2024
Accepted December 20, 2024
Published online March 5, 2025
Corresponding Author
Can Liu
ORCID [https://orcid.org/0009-0007-3289-6920](https://orcid.org/0009-0007-3289-6920)[ ](https://orcid.org/0009-0007-3289-6920)[E-mail](E-mail canliu520@sina.com)[ canliu520@sina.com](E-mail canliu520@sina.com)
Renwang Hu
ORCID [https://orcid.org/0009-0009-8569-1122](https://orcid.org/0009-0009-8569-1122)[ ](https://orcid.org/0009-0009-8569-1122)[E-mail](E-mail huhu1566@sina.com)[ huhu1566@sina.com](E-mail huhu1566@sina.com) | Background/Aims: To construct a new model based on folate receptor-positive circulating tumor cells (FR+-CTC) for the preoperative prediction of peritoneal metastasis in gastrointestinal malignancies and to apply this model in clinical practice.
Methods: Patients with gastrointestinal malignancies who had undergone preoperative FR+-CTC counts were retrospectively collected. Risk factors for peritoneal metastasis in patients with gastrointestinal malignancies were identified using a logistic regression model. The “pROC” package in R software was employed to plot the receiver operating characteristic curve for predicting peritoneal metastasis in these patients based on identified risk factors. The Spearman correlation analysis was performed to assess the relationship between FR+-CTC counts and risk factors. Results: A total of 396 patients meeting the inclusion criteria were finally included in the study. The number of FR+-CTC, albumin level, total protein level, and cancer antigen 125 (CA-125) level were identified as risk factors affecting peritoneal metastasis in gastrointestinal malignancies. The number of FR+-CTC was significantly negatively correlated with albumin (R=–0 .21, p<0 .001) and total protein levels (R=–0 . 10, p=0 .047), and a positively correlated with CA-125 level (R=0 . 15, p=0 .004) . The number of FR+-CTCs was significantly higher in patients with peritoneal metastasis, lymph node metastasis, vascular invasion, neural invasion, and in those with stage T3-4 and III-IV gastrointestinal malignancies (p<0 .05 for all) . The model demonstrated stable predictive capacity, as validated through 10-fold cross-validation.
Conclusions: FR+-CTCs can serve as a novel biomarker for gastrointestinal malignancies. Anew model based on FR+-CTCs demonstrated strong predictive capabilities for the preoperative assessment of peritoneal metastasis in gastrointestinal cancers. (Gut Liver, 2025;19:536-547)
Key Words: Stomach neoplasms; Colorectal neoplasms; Folate receptor-positive circulating tumor cells; Peritoneal metastasis; Gastrointestinal malignancies | | |
INTRODUCTION | | lating tumor cells (CTC) have gained increasing attention in cancer research in recent years.6-9 They are tumor cells | | Gastrointestinal malignancies are among the most com- | | that have detached from the primary tumor or metastatic | | mon cancers globally,1,2 with their prognosis often hinging | | sites and entered the bloodstream. Considered as a form of | | on the occurrence of peritoneal metastasis. Once perito- | | “real-time liquid biopsy,” CTC are seen as a powerful tool | | neal metastasis

FAQs

What was the study aim regarding FR+-CTC?

To construct a new model based on folate receptor-positive circulating tumor cells for preoperative prediction of peritoneal metastasis in gastrointestinal malignancies and apply it in clinical practice.

How were risk factors and predictive performance evaluated?

Risk factors were identified using logistic regression, ROC curves were generated with the pROC package in R, and Spearman correlation was used to assess relationships between FR+-CTC counts and risk factors. Predictive capacity was validated using 10-fold cross-validation.

Which variables were identified as risk factors for peritoneal metastasis?

FR+-CTC count, albumin level, total protein level, and cancer antigen 125 (CA-125) level.

Sep 23, 2026

Uploaded by Rizky