{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:12:04Z","timestamp":1782407524839,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The noninvasive prediction of pathological high\u2010risk factors in stage I NSCLC patients before surgery remains an area for further investigation, and circulating stem cancer cells\u00a0are a potential predictive diagnostic indicator. Identifying these factors preoperatively can guide treatment decisions and may improve outcomes. Here, we aim to explore CD133\u2010positive circulating tumor cells (CTCs) in stage I patients of NSCLC to predict pathological high\u2010risk factors of patients, thereby aiding clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 192 Stage I NSCLC patients were finally enrolled and underwent surgical intervention. We assessed the level of CD133\u2010positive CTCs by employing the telomerase reverse Transcriptase\u2010Based CTC Detection method. The Least Absolute Shrinkage and Selection Operator method (LASSO) and logistic regression were used to analyze the association between CD133\u2010positive CTCs with pathological high\u2010risk factors and construct a diagnostic model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among all the enrolled patients, postoperative pathology confirmed that 12 patients had pathological high\u2010risk factors, while 180 patients had no high\u2010risk factors. The median count of CD133\u2010positive CTCs before surgery in patients with high\u2010risk factors was recorded at 1.58\u2009\u00b1\u20091.83, significantly higher than 0.767\u2009\u00b1\u20091.13 observed in the group without high\u2010risk factors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). Following feature selection by LASSO regression and multivariate logistic regression, it was determined that CD133\u2010positive CTCs, CT imaging nodule features, and elevated CEA levels can be combined as diagnostic indicators for pathological high\u2010risk factors in NSCLC patients. The ROC curve derived from internal bootstrap validation, alongside the calibration and DCA plots, affirmed the model's accuracy and predictive capability. After follow\u2010up, we found that patients without high\u2010risk pathological factors showed better PFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study indicated that CD133\u2010positive CTCs were associated with pathological high\u2010risk factors, and the detection of CD133\u2010positive CTCs may assist treatment decision\u2010making for patients of NSCLC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71303","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:52:29Z","timestamp":1761807149000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic and Predictive Value of CD133\u2010Positive Circulating Tumor Cells as an Indicator of Pathological High\u2010Risk Factors for Stage I Non\u2010Small Cell Lung Cancer"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5302-806X","authenticated-orcid":false,"given":"Huandong","family":"Huo","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoheng","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Xie","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitai","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3150-2751","authenticated-orcid":false,"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousheng","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00444-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.02.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2204.0023"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.4401"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx222"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e318206a221"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2020.05.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.188"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.09.028"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000617"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14062"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.05.102"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2020.12.001"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-08113-0"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-020-00627-5"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-019-0293-2"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2018.05.014"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4123622"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-018-1071-2"},{"issue":"11","key":"e_1_2_10_22_1","article-title":"Combination of CT and Telomerase+ Circulating Tumor Cells Improves Diagnosis of Small Pulmonary Nodules","volume":"6","author":"Zhang W.","year":"2021","journal-title":"JCI Insight"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx127"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2015.09.009"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.948441"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26760"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07366-z"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748231197973"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2019.05.012"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.01.037"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-019-02972-6"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758835920937893"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-23-246"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150714"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-33803-x"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2011.03.019"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2011.11.012"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-015-0891-0"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezae059"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20421"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.3716"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0593-1"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yexcr.2015.04.018"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/35102167"},{"issue":"11","key":"e_1_2_10_45_1","first-page":"1721","article-title":"Cancer Stem Cell","volume":"34","author":"Sakashita H.","year":"2007","journal-title":"Gan to Kagaku Ryoho"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-13-166"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.6890"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2022.13352"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4086"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24690"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2024.102774"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71303","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71303","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:35:03Z","timestamp":1777530903000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,29]]},"references-count":50,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/cam4.71303"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71303","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,29]]},"assertion":[{"value":"2024-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71303"}}