Tara E Henn1, Ashley N Anderson2, Yvette R Hollett1, Thomas L Sutton3, Brett S Walker3, John R Swain2, David A Sauer1,4, Daniel R Clayburgh1,5,6, Melissa H Wong2,6. 1. Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon, USA. 2. Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon, USA. 3. Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA. 4. Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA. 5. Operative Care Division, Veterans Affairs Medical Center, Portland, Oregon, USA. 6. Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.
Abstract
BACKGROUND: Levels of circulating hybrid cells (CHCs), a newly identified circulating tumor cell (CTC), correlate with disease stage and progression in cancer. We investigated their utility to risk-stratify patients with clinically N0 (cN0) oral cavity squamous cell carcinoma (OCSCC), and to identify patients with occult cervical lymph node metastases (pN+). METHODS: We analyzed peripheral blood samples for CHCs with co-expression of cytokeratin (tumor) and CD45 (leukocyte) from 22 patients with cN0 OCSCC using immunofluorescence microscopy, then correlated levels with pathologic lymph node status. RESULTS: CHC levels exceeded CTCs and correlated with the presence of both clinically overt (p = 0.002) and occult nodal metastases (p = 0.006). CONCLUSIONS: For evaluated cN0 OCSCC patients, those with cN0 → pN+ status harbored elevated CHC levels compared to patients without occult disease. Our findings highlight a promising blood-based biologic assay with potential utility to determine the necessity of surgical neck dissection for staging and treatment.
BACKGROUND: Levels of circulating hybrid cells (CHCs), a newly identified circulating tumor cell (CTC), correlate with disease stage and progression in cancer. We investigated their utility to risk-stratify patients with clinically N0 (cN0) oral cavity squamous cell carcinoma (OCSCC), and to identify patients with occult cervical lymph node metastases (pN+). METHODS: We analyzed peripheral blood samples for CHCs with co-expression of cytokeratin (tumor) and CD45 (leukocyte) from 22 patients with cN0 OCSCC using immunofluorescence microscopy, then correlated levels with pathologic lymph node status. RESULTS: CHC levels exceeded CTCs and correlated with the presence of both clinically overt (p = 0.002) and occult nodal metastases (p = 0.006). CONCLUSIONS: For evaluated cN0 OCSCC patients, those with cN0 → pN+ status harbored elevated CHC levels compared to patients without occult disease. Our findings highlight a promising blood-based biologic assay with potential utility to determine the necessity of surgical neck dissection for staging and treatment.
Authors: Charles E Gast; Alain D Silk; Luai Zarour; Lara Riegler; Joshua G Burkhart; Kyle T Gustafson; Michael S Parappilly; Minna Roh-Johnson; James R Goodman; Brennan Olson; Mark Schmidt; John R Swain; Paige S Davies; Vidya Shasthri; Shinji Iizuka; Patrick Flynn; Spencer Watson; James Korkola; Sara A Courtneidge; Jared M Fischer; Jerry Jaboin; Kevin G Billingsley; Charles D Lopez; Julja Burchard; Joe Gray; Lisa M Coussens; Brett C Sheppard; Melissa H Wong Journal: Sci Adv Date: 2018-09-12 Impact factor: 14.136
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