Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7921
Peer-review started: December 5, 2014
First decision: December 26, 2014
Revised: January 11, 2015
Accepted: February 13, 2015
Article in press: February 13, 2015
Published online: July 7, 2015
This study investigated whether changes in circulating tumor cell (CTC) numbers reflect tumor progression and treatment efficacy in esophageal squamous cell carcinoma (ESCC). A 47-year-old male patient with ESCC is presented in this case study. The patient was evaluated for a series of serum tumor markers and subjected to radiological examinations before and after surgery and during follow-up over the course of five years. In addition, the CTCs in 7.5 mL of peripheral blood were enriched by magnetic-activated cell sorting negative selection and identified by immunofluorescence staining. Serum tumor markers remained within normal ranges and were discordant with imaging scans during the follow-up. Initially, one CTC was detected in the peripheral blood sample, and 14 were observed seven days after the operation. After 12 wk, subcutaneous metastases and bone metastases occurred, and the number of CTCs increased to 84. After 48 wk, lung metastases were noted, and the CTC level was 21. At 104 wk, the number of CTCs was 14, and disease recurrence was detected by positron emission tomography-computed tomography. The CTC counts were in accord with the imaging studies at several time points. The additional information provided by CTC enumeration could thus facilitate monitoring of disease status and treatment efficacy and provide support for treatment decisions.
Core tip: We report a follow-up of a 47-year-old male patient with esophageal squamous cell carcinoma in this study. In addition to the conventional examination, a novel workflow was performed to detect circulating tumor cells (CTCs). We evaluated the relationship between CTC characteristics and other tests. The serum tumor markers were normal and thus did not appear to reflect changes in the disease, whereas the number of CTCs fluctuated with the disease progression and treatment and coincided with imaging studies performed during the follow-up. This case highlights CTCs as a useful diagnostic tool with potential applications during treatment.