Abstract: Objective To explore the diagnostic value of folate receptor-positive circulating tumor cells(FR+CTCs) in patients with hepatocellular carcinoma(HCC). Methods From October 2020 to August 2021,91 cases of HCC in the Department of Liver Surgery of Tongji Hospital were prospectively collected,and the detection values of FR + CTCs in peripheral blood bodies were measured by immunomagnetic bead negative screening and targeted fluorescence quantitative PCR.The patients were divided into non-vascular invasion group (NVI)( n =30),microvascular invasion group (MVI)( n =26) and portal vein tumor thrombus group(PVTT)( n =35) according to preoperative imaging and postoperative pathological results.The difference of FR + CTCs among 3 groups was analyzed. Results The average values of FR + CTCs in the three groups were (10.52±2.21)FU/3 ml,(12.35±2.47)FU/3 ml,(14.79±3.68)FU/3 ml( P <0.05).There was a positive correlation between the detection value of FR + CTCs and the degree of vascular invasion in patients with HCC( r=0.499,P <0.05).FR + CTCs were used as auxiliary diagnostic indicators for vascular invasion and PVTT,and the area under the ROC curve was 0.769 (95%CI was 0.668-0.869) and 0.830(95%CI was 0.733-0.928),respectively.When the cut-off points were 12.35 FU/3 ml and 11.8 FU/3 ml,respectively,the diagnostic sensitivity was  0.672  and 0.829,and the specificity was 0.767 and 0.733,respectively. Conclusion The detection value of FR + CTCs was positively correlated with the degree of vascular invasion in HCC patients,and the detection value of FR + CTCs had higher auxiliary diagnostic value for patients with vascular invasion and PVTT,but lower diagnostic value for MVI in patients with HCC.

Key words: circulating tumor cells, folate receptor, hepatocellular carcinoma, vascular invasion