title: Significance of circulating tumor cells in patients with squamous cell carcinoma of the head and neck: initial results.
abstract: OBJECTIVE
  to present and discuss a high-performance negative depletion method for the isolation of circulating tumor cells (CTCs) in the blood of patients with head and neck cancer and to determine the correlation between the presence of CTCs and early clinical outcome in these patients.
  
  
  METHODS
  prospective clinical follow-up study of patients with squamous cell carcinoma of the head and neck (SCCHN) undergoing surgical intervention, who had peripheral blood examined for the presence of CTCs.
  
  
  METHODS
  the study population comprised 48 patients diagnosed as having SCCHN and undergoing surgical intervention.
  
  
  METHODS
  a negative depletion process to isolate and quantify CTCs from the blood of patients with SCCHN using immunomagnetic separation was developed and validated. Immunostaining for cytokeratin was performed on the enriched samples to determine the number of CTCs extracted from each patient's blood sample. Correlation of the presence of CTCs, tumor stage, nodal status, clinical characteristics, and outcome was made.
  
  
  METHODS
  disease-free survival.
  
  
  RESULTS
  our initial data, that have a mean follow-up of 19.0 months, suggest that patients with no detectable CTCs per milliliter of blood had a significantly higher probability of disease-free survival (P = .01). There was no correlation between the presence of CTCs with regard to age, sex, tumor site, stage, or nodal involvement.
  
  
  CONCLUSIONS
  our enrichment technology, based on the removal of normal cells, has been used on the peripheral blood of patients with head and neck cancer for which follow-up data were collected. If no CTCs were present, a statistically significant improved disease-free survival was observed in SCCHN. A blood test with such a prognostic capability could have important implications in the treatment of patients with head and neck cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Ohio State University and Nationwide Children's Hospital, 555 S 18th St, Columbus, OH 43205, USA. kris.jatana@osumc.edu
authors.forename: Kris R
authors.initials: KR
authors.lastname: Jatana
authors.forename: Priya
authors.initials: P
authors.lastname: Balasubramanian
authors.forename: Jas C
authors.initials: JC
authors.lastname: Lang
authors.forename: Liying
authors.initials: L
authors.lastname: Yang
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Jatana
authors.forename: Elisabeth
authors.initials: E
authors.lastname: White
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
authors.forename: David E
authors.initials: DE
authors.lastname: Schuller
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Teknos
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Chalmers
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D018189:Immunomagnetic Separation / Q000379:methods; D007633:Keratins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D007633:Keratins