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三叶草王铁虫 (正式写手)
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The most discriminating models in our study included CTM. The rarity of such disease derived cell clusters, ranging from a few cells aggregated together to “mega-clusters,” and recent molecular characteriza tions describing their EMT phenotype suggest that clusters may be a more “cancerous” subtype of putative CTCs. Our data recapitulated this clinically as CTM were the strongest diagnostic in our models using not only a candidate-driven approach, but when employing a lasso model that agnostically selected CTM as the most important HD-CTC feature along with other clinical data. We also found that, unsurprisingly, the HD-CTC assay will detect CTC-like events in high-risk patients with other competing diagnoses This suggests that, although enumeration appears to be clinically useful, even sensitive methods for detecting CTCs will benefit from additional molecular characterization to differentiate circulating epithelial cells (CECs) from CTCs regardless of platform type. Using additional protein biomarkers, next generation sequencing for single mutational or whole genome copy number variation analysis to define cells with pathognom -onic hallmarks of cancer is one way to approach this issue that we are currently investigating. Whether inconsequential CECs arise from competing inflammatory lesions other than lung cancer or clinically undetected premalignant lesions remains a question that will be answered over time as the patient cohort matures. we acknowledge that its observational nature may have led to several biases in the collection of the data that render its findings preliminary. These include ：an inherent spectrum bias at participating centers; the inclusion of patients who only underwent PET-CT that may have led to identifying larger benign lesions than one would normally see in an evaluation setting; an additional bias toward identifying larger benign lesions that had a more expeditious work-up compared to smaller lesions that remain indeterminate (and thusly excluded from our analysis) and are being followed over time. |
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