title: Circulating epithelial cell enumeration facilitates the identification and follow-up of a patient with early stage papillary thyroid microcarcinoma: A case report.
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.
authors.affiliation: 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.
authors.forename: Chia-Hsun
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, ROC.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Graduate Institute of Biochemical and Biomedical Engineering, Chang Gung University, Taoyuan 333, Taiwan, ROC.
authors.forename: Song-Bin
authors.initials: SB
authors.lastname: Huang
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, ROC; Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan, ROC.
authors.forename: Chuen
authors.initials: C
authors.lastname: Hsueh
authors.affiliation: Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 333, Taiwan, ROC.
authors.forename: Hsung-Ling
authors.initials: HL
authors.lastname: Hsu
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan, ROC.
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.affiliation: Graduate Institute of Biochemical and Biomedical Engineering, Chang Gung University, Taoyuan 333, Taiwan, ROC. Electronic address: mhwu@mail.cgu.edu.tw.
authors.forename: Min-Hsien
authors.initials: MH
authors.lastname: Wu
authors.affiliation: 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.
authors.forename: Ching-Ping
authors.initials: CP
authors.lastname: Tseng
authors.affiliation: 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.
authors.forename: Jen-Der
authors.initials: JD
authors.lastname: Lin
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D002452:Cell Count; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D049268:Positron-Emission Tomography; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D013954:Thyroglobulin
keywords: Circulating epithelial cells; Epithelial cell adhesion molecule; Papillary thyroid microcarcinoma; Thyroglobulin