Abstract
Background Clinical significance of circulating tumor cell (CTC) count, mesenchymal CTCs (MCTCs), and survivin in patients with thyroid cancer remains unclear. We evaluated the relationship between the expression of different CTC subtypes or survivin and the prognosis in patients with thyroid cancer. Patients and Methods. This study enrolled 164 patients with thyroid cancer who were diagnosed from January 2013 to September 2020 in our hospital. Among these patients, there were 73 cases with papillary thyroid cancer (PTC), 60 cases with follicular thyroid cancer (FTC), 12 medullary thyroid cancers (MTC), 10 poorly differentiated thyroid cancers (PDTC), 9 anaplastic thyroid cancers, and 10 control patients with nonmalignant thyroid nodules based on their histopathological characteristics. Only 5 milliliters (mL) of peripheral blood from the patients with thyroid cancer and control was used to detect the CTC cell number via CanPatrol capture technique before treatments. We also isolated mononuclear cells (MNC) from the peripheral blood and performed quantity reverse transcriptase polymerase chain reaction (qPCR) for survivin gene expression among these patients. Results The overall positive rates of CTC at diagnosis were 56.1%. The relapse and metastasis rates in PTC and FTC patients with more than 6 CTCs and positive MCTCs were significantly higher than those in the patients with 6 or less than 6 CTCs and MCTCs. It was also found that these patients with >6 CTCs and MCTCs had shorter progression-free survival (PFS). Additionally, the survivin level of the patients with thyroid cancer was strongly relative to differentiation grades of thyroid cancers. Conclusions The detection of more than six of total CTCs and positive MCTCs in the patients with differentiated thyroid cancer is an excellent biomarker for predicting the prognosis of patients. Survivin also is a good biomarker for thyroid cancer differentiation.
Highlights
Worldwide, palpable thyroid nodules can be detected in around 5% of women and 1% of men [1]
According to the World Health Organization (WHO) on the latest classification of thyroid cancer in 2017 [6], thyroid cancer is mainly classified into papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), Hürthle cell carcinoma (HCC), medullary thyroid carcinoma (MTC), poorly differentiated thyroid carcinoma (PDTC), and anaplastic thyroid carcinoma based on their histopathological characteristics [7, 8]
We found that if total circulating tumor cell (CTC) and mesenchymal CTCs (MCTCs) of the papillary thyroid cancer (PTC) or follicular thyroid cancer (FTC) patients were high at diagnosis, they were most likely to have quick tumor progress
Summary
Palpable thyroid nodules can be detected in around 5% of women and 1% of men [1]. According to the World Health Organization (WHO) on the latest classification of thyroid cancer in 2017 [6], thyroid cancer is mainly classified into papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), Hürthle (oncocytic) cell carcinoma (HCC), medullary thyroid carcinoma (MTC), poorly differentiated thyroid carcinoma (PDTC), and anaplastic thyroid carcinoma based on their histopathological characteristics [7, 8]. This study enrolled 164 patients with thyroid cancer who were diagnosed from January 2013 to September 2020 in our hospital Among these patients, there were 73 cases with papillary thyroid cancer (PTC), 60 cases with follicular thyroid cancer (FTC), 12 medullary thyroid cancers (MTC), 10 poorly differentiated thyroid cancers (PDTC), 9 anaplastic thyroid cancers, and 10 control patients with nonmalignant thyroid nodules based on their histopathological characteristics. Survivin is a good biomarker for thyroid cancer differentiation
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