Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings

Christy E. Cauley, Martha B. Pitman, Jiahua Zhou, James Perkins, Birte Kuleman, Andrew S. Liss, Carlos Fernandez-Del Castillo, Andrew L. Warshaw, Keith D. Lillemoe, Sarah P Thayer

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30 Citations (Scopus)

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. Study Design 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.

Original languageEnglish (US)
Article number7920
Pages (from-to)699-707
Number of pages9
JournalJournal of the American College of Surgeons
Volume221
Issue number3
DOIs
StatePublished - Sep 1 2015

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Epithelial Cells
Adenocarcinoma
Healthy Volunteers
Circulating Neoplastic Cells
Equipment and Supplies
Neoplasms
Neuroendocrine Tumors
Cell Separation
Chronic Pancreatitis
Medical Records
Cohort Studies
Control Groups

ASJC Scopus subject areas

  • Surgery

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Circulating Epithelial Cells in Patients with Pancreatic Lesions : Clinical and Pathologic Findings. / Cauley, Christy E.; Pitman, Martha B.; Zhou, Jiahua; Perkins, James; Kuleman, Birte; Liss, Andrew S.; Fernandez-Del Castillo, Carlos; Warshaw, Andrew L.; Lillemoe, Keith D.; Thayer, Sarah P.

In: Journal of the American College of Surgeons, Vol. 221, No. 3, 7920, 01.09.2015, p. 699-707.

Research output: Contribution to journalArticle

Cauley, CE, Pitman, MB, Zhou, J, Perkins, J, Kuleman, B, Liss, AS, Fernandez-Del Castillo, C, Warshaw, AL, Lillemoe, KD & Thayer, SP 2015, 'Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings', Journal of the American College of Surgeons, vol. 221, no. 3, 7920, pp. 699-707. https://doi.org/10.1016/j.jamcollsurg.2015.05.014
Cauley, Christy E. ; Pitman, Martha B. ; Zhou, Jiahua ; Perkins, James ; Kuleman, Birte ; Liss, Andrew S. ; Fernandez-Del Castillo, Carlos ; Warshaw, Andrew L. ; Lillemoe, Keith D. ; Thayer, Sarah P. / Circulating Epithelial Cells in Patients with Pancreatic Lesions : Clinical and Pathologic Findings. In: Journal of the American College of Surgeons. 2015 ; Vol. 221, No. 3. pp. 699-707.
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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. Study Design 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.",
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AU - Cauley, Christy E.

AU - Pitman, Martha B.

AU - Zhou, Jiahua

AU - Perkins, James

AU - Kuleman, Birte

AU - Liss, Andrew S.

AU - Fernandez-Del Castillo, Carlos

AU - Warshaw, Andrew L.

AU - Lillemoe, Keith D.

AU - Thayer, Sarah P

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N2 - 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. Study Design 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.

AB - 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. Study Design 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.

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