NOTCH1 and lung cancer: CTCs were detected in 62.5% (30/48). Using NGS, > 50% of patients had 4 commonly mutated genes, NOTCH1, IGF2, EGFR, and PTCH1. 47.37% (9/19) patients had ARIDH1 mutations. LC-MS untargeted metabolomics found 100 different metabolites, and 10 different metabolites were identified through analysis. This may have potential clinical application value in the diagnosis of CTC-positive early-stage lung cancer (AUC >0.9).