title: Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings.
abstract: BACKGROUND
  Circulating epithelial cell (CEC) isolation has provided diagnostic and prognostic information for a variety of cancers, previously supporting their identity as circulating tumor cells in the literature. However, we report CEC findings in patients with benign, premalignant, and malignant pancreatic lesions using a size-selective filtration device.
  
  
  METHODS
  Peripheral blood samples were drawn from patients found to have pancreatic lesions on preoperative imaging at a surgical clinic. Blood was filtered using ScreenCell devices, which were evaluated microscopically by a pancreatic cytopathologist. Pathologic data and clinical outcomes of these patients were obtained from medical records during a 1-year follow-up period.
  
  
  RESULTS
  Nine healthy volunteers formed the control group and were found to be negative for CECs. There were 179 patients with pancreatic lesions that formed the study cohort. Circulating epithelial cells were morphologically similar in patients with a variety of pancreatic lesions. Specifically, CECs were identified in 51 of 105 pancreatic ductal adenocarcinomas (49%), 7 of 11 neuroendocrine tumors (64%), 13 of 21 intraductal papillary mucinous neoplasms (62%), and 6 of 13 patients with chronic pancreatitis. Rates of CEC identification were similar in patients with benign, premalignant, and malignant lesions (p = 0.41). In addition, CEC findings in pancreatic ductal adenocarcinoma patients were not associated with poor prognosis.
  
  
  CONCLUSIONS
  Although CECs were not identified in healthy volunteers, they were identified in patients with benign, premalignant, and malignant pancreatic lesions. The presence of CECs in patients presenting with pancreatic lesions is neither diagnostic of malignancy nor prognostic for patients with pancreatic ductal adenocarcinoma.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: ccauley@partners.org.
authors.forename: Christy E
authors.initials: CE
authors.lastname: Cauley
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Martha B
authors.initials: MB
authors.lastname: Pitman
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Jiahua
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: James
authors.initials: J
authors.lastname: Perkins
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Birte
authors.initials: B
authors.lastname: Kuleman
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Liss
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez-Del Castillo
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Warshaw Institute for Pancreatic Cancer Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Thayer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010182:Pancreatic Diseases / Q000097:blood / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology*; D011230:Precancerous Conditions / Q000097:blood / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies