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Micrometastatic Tumor Detection in Patients With Head and Neck Cancer
A Preliminary Report
Ari Wirtschafter, MD;
Michael S. Benninger, MD;
Thomas J. Moss, MD;
Tehila Umiel, PhD;
Kathleen Blazoff, MSN, RN;
Maria J. Worsham, PhD
Arch Otolaryngol Head Neck Surg. 2002;128:40-43.
Objective To apply a new immunocytochemistry (ICC) assay to peripheral blood samples
for micrometastatic circulating tumor cell detection in patients with head
and neck squamous cell cancer (HNSCC).
Design The ICC assay uses established monoclonal antibodies that bind to tumor-associated
antigens combined with an enrichment system that uses positive selection with
anti-human epithelial antigen (EpCAM antibody) to detect circulating tumor
cells.
Subjects Eighteen consecutive patients newly diagnosed as having HNSCC are described.
Results Of the 18 patients, 8 (44%) demonstrated circulating tumor cells using
the ICC assay. The numbers of patients positive for circulating tumor cells
per stage are as follows: stage I, 1 of 1; stage II, 0 of 2; stage III, 2
of 5; stage IV, 5 of 6; and unknown stage, 0 of 4. The numbers of patients
positive for circulating tumor cells per location are as follows: oral cavity,
1 of 2; oropharynx, 3 of 4; glottic area, 3 of 5; supraglottic area, 1 of
3; and unknown primary 0 of 4.
Conclusions Circulating tumor cells were identified in almost half of the patients
using the ICC assay. In a literature review, we were not able to identify
previous reports of circulating tumor cell detection in patients with HNSCC
from peripheral blood samples using ICC or identify any study that has attempted
to quantify circulating tumor cell levels. Although the clinical implications
of circulating tumor cells in micrometastatic tumor detection in patients
with HNSCC are still unknown, they may be significant. Long-term follow-up
may help elucidate the patients in whom conventional treatment may fail and,
thus, those who may benefit from different treatment; it may also assist with
the detection of recurrence with a simple blood collection.
From the Department of Otolaryngology–Head and Neck Surgery (Drs
Wirtschafter and Benninger and Ms Blazoff) and Research Division, Department
of Otolaryngology–Head and Neck Surgery (Dr Worsham), Henry Ford Hospital,
Detroit, Mich; and Clinical Protocol Development (Dr Moss) and Research and
Development (Dr Umiel), IMPATH/BIS Laboratories, Los Angeles, Calif.
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