Detection And Significance Of Circulating Tumor Cells In Patients With Thyroid Cancer

Objective Detect the circulating tumor cells(CTCs)in peripheral blood samples of patients with thyroid cancer.To evaluate the clinical significance of CTCs in patients with thyroid cancer.Methods Peripheral blood samples were obtained from twenty-eight patients with thyroid cancer,and five patients with benign thyroid nodules.Peripheral blood samples were collected and filtered with a 8-?m diameter pores calibrated membrane.Then we established nucleic acid probes and adopted epithelial transcripts[EpCAM;keratins(KRT)8,18 and 19]to detect epithelial phenotypes of CTC(E+CTC),and mesenchymal transcripts(Vimentin and Twist)to identify mesenchymal phenotypes of CTCs(M+CTC)and epithelial/mese nchymal phenotypes of CTC(E+/M+CTC)by a multiplex RNA-insitu hybridiz ation(RNA-ISH)assay.Finally accout three phenotypes of CTCs.Results Among twenty-eight patients with thyroid cancer,CTCs were found in peripheral blood samples of twenty patients,and only one blood sample had detected no CTC(96.4%),CTCs counts ranged from 3-36 per tube,and the proportion of E+/M+CTC was the largest.In the control group,four of five patients with benign nodules were also detected CTCs,but the number of cells were scarce,CTCs were?2 per tube.CTCs were not associated wit h age and sex(p>0.05).Comparing CTCs,E+/M+CTC and M+CTC counts in patients with different clinicopathological features,the patients undergoing 1 ymph-node metastasis of thyroid carcinoma were higher than those without lymph-node metastasis(P<0.01),and M+CTC positive rate in patients undergoing metastasis was high than them without metastasis(P<0.01).Patients with large size of tumor(?1 cm)was more than those with small tumor(<1cm)(p<0.05).And,There was no significant association between suspicious ultrasonic signals of nodule boundary,blood signal and small calcification.Conclusion 1.CTCs accouts can help distinguish it benign or malignant,the presence of CTCs>2 per tube in patients with thyroid nodule was inclined to malignance.2.The numbers of CTCs were not associated with age,sex,and kinds of suspicious ultrasonic signals,but CTCs accouts were related to th e size of primary tumor and lymph-node metastasis in patients with thyroid cancer.3.Applying CanPatrol CTC enrichment technique not noly helped isolate E+CTC and E+/M+CTC,and also captured some M+CTC.It improved detective CTCs accouts,and confirmed active epithelial-mesenchymal transition(E MT)in thyroid cancer.Furthermore our findings suggested that the existence of M+CTC might have a positive correlation with tumor lymph-node metastasis.