Evaluating The Sensitivity, Specificity, And Predictive Accuracy Of Liquid Biopsy Across NSCLC Stages

Abstract

The majority of lung cancer cases belong to the NSCLC category, yet patients often present with advanced disease, which reduces their treatment effectiveness. The current standard of tissue biopsy molecular profiling requires alternative solutions because of its invasive characteristics, along with restrictive sampling capabilities. Diagnostic precision of liquid biopsy through circulating tumor DNA (ctDNA) analysis remains insufficiently defined for all clinical stages. The research investigated liquid biopsy-based next-generation sequencing (NGS) against tissue-based NGS in 120 subjects who had never received treatment for NSCLC at a single medical facility. We tested matched tissue and plasma samples while using digital PCR to investigate cases showing differences between results. The analysis showed a 70.8% concordance rate and 85.9% sensitivity, together with 75.0% specificity. The recognition rate of Stage III–IV patients (94.3%) surpassed the exposure rate of patients in Stage I–II (68.0%). The positive predictive value (PPV) remained stable throughout all stages, but the negative predictive value (NPV) decreased in affected persons with early-stage NSCLC. The research findings demonstrate that liquid biopsy serves as an additional diagnostic method for NSCLC patients who have restricted tissue availability in advanced stages. This research enhances the case for using liquid biopsy in precision medicine by delivering performance results per disease stage and demonstrating the necessity to validate findings across larger patient groups in multiple centers.