Circulating epithelial cell enumeration facilitates the identification and follow-up of a patient with early stage papillary thyroid microcarcinoma: A case report

Chia-Hsun Hsieh; Hung-Chih Lin; Song-Bin Huang; Chuen Hsueh; Hsung-Ling Hsu; Hung-Ming Wang; Min-Hsien Wu; Ching-Ping Tseng; Jen-Der Lin

doi:10.1016/j.cca.2015.12.030

Circulating epithelial cell enumeration facilitates the identification and follow-up of a patient with early stage papillary thyroid microcarcinoma: A case report

Clin Chim Acta. 2016 Feb 15:454:107-11. doi: 10.1016/j.cca.2015.12.030. Epub 2016 Jan 2.

Authors

Chia-Hsun Hsieh¹, Hung-Chih Lin², Song-Bin Huang³, Chuen Hsueh⁴, Hsung-Ling Hsu⁵, Hung-Ming Wang⁶, Min-Hsien Wu⁷, Ching-Ping Tseng⁸, Jen-Der Lin⁹

Affiliations

¹ Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan, ROC; Department of Chemical and Materials Engineering, Chang Gung University, Taoyuan 333, Taiwan, ROC.
² Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, ROC.
³ Graduate Institute of Biochemical and Biomedical Engineering, Chang Gung University, Taoyuan 333, Taiwan, ROC.
⁴ Department of Pathology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, ROC; Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan, ROC.
⁵ Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 333, Taiwan, ROC.
⁶ Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan, ROC.
⁷ Graduate Institute of Biochemical and Biomedical Engineering, Chang Gung University, Taoyuan 333, Taiwan, ROC. Electronic address: mhwu@mail.cgu.edu.tw.
⁸ Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, ROC; Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan, ROC; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 333, Taiwan, ROC; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, ROC. Electronic address: ctseng@mail.cgu.edu.tw.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan, ROC. Electronic address: einjd@adm.cgmh.org.tw.

PMID: 26751809
DOI: 10.1016/j.cca.2015.12.030

Abstract

Background: This study examines whether the measurement of circulating epithelial cells (CECs) facilitates the identification and follow-up of a patient with thyroid cancer.

Methods: A 29-y-old woman with no cancer history was enrolled as a healthy control in a CEC study. CECs were enriched from the peripheral blood by the negative selection system PowerMag. Various medical examinations were performed on the patient to establish the diagnosis and to follow-up her disease status during treatment.

Results: This patient had unexpectedly high CEC counts that were sustained for more than two weeks. Thyroid gland ultra-sonography revealed lesions in the left lobe that could not be confirmed as cancer by magnetic resonance imaging, (18)F-fludeoxyglucose-positron emission tomography-computed tomography or cytopathological analysis, but were histologically confirmed after thyroidectomy as papillary thyroid microcarcinoma. Both the CEC count and serum thyroglobulin (Tg) concentration were significantly decreased after thyroidectomy, and they and the patient's disease status were correlated during remnant ablation therapy. The CEC count returned to normal when the patient was disease-free 10 months after thyroidectomy.

Conclusions: CEC testing facilitates the identification of individuals at risk for cancer. Longitudinal follow-up of the CEC count may complement serum Tg testing for monitoring the status of patients with thyroid cancer.

Keywords: Circulating epithelial cells; Epithelial cell adhesion molecule; Papillary thyroid microcarcinoma; Thyroglobulin.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Carcinoma, Papillary / blood
Carcinoma, Papillary / diagnosis*
Carcinoma, Papillary / pathology*
Carcinoma, Papillary / surgery
Cell Count
Epithelial Cells / pathology*
Female
Fluorodeoxyglucose F18
Humans
Positron-Emission Tomography
Thyroglobulin / blood
Thyroid Neoplasms / blood
Thyroid Neoplasms / diagnosis*
Thyroid Neoplasms / pathology*
Thyroid Neoplasms / surgery
Thyroidectomy
Tomography, X-Ray Computed

Substances

Fluorodeoxyglucose F18
Thyroglobulin

Supplementary concepts

Papillary Thyroid Microcarcinoma