Measurement of circulating tumor cells in squamous cell carcinoma of the head and neck and patient outcomes

  • T. M. Morgan
  • X. Wang
  • X. Qian
  • J. M. Switchenko
  • S. Nie
  • K. R. Patel
  • R. J. Cassidy
  • D. M. Shin
  • J. J. Beitler
Research Article



We report the outcomes of patients with squamous cell carcinoma of the head and neck (HNSCC) whose circulating tumor cells (CTCs) were quantified using surface-enhanced Raman scattering (SERS) nanotechnology.


SERS tagged with EGF was used to directly measure targeted CTCs. Patient charts were retrospectively reviewed. An optimal cut point for CTCs in 7.5 ml of peripheral blood predictive of for distant metastasis-free survival (DMFS) was identified by maximizing the log-rank statistic. An ROC analysis was also performed.


Of 82 patients, 13 experienced metastatic progression. The optimal cut point for DMFS was 675 CTCs (p = 0.047). For those with distant recurrence (n = 13) versus those without distant recurrence (n = 69), the CTC cut point which results in the largest combined sensitivity and specificity values is also 675 (sensitivity = 69%, specificity = 68%).


Liquid biopsy techniques in HNSCC show promise as a means of identifying patients at greater risk of disease progression.


Neoplastic cells, circulating Precision medicine Carcinoma, squamous cell of head and neck Prognosis Neoplasm metastasis 



Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflicts of interest

The authors declare they have no conflicts of interest.

Research involving human participants and/or animals

This study was approved by our institutional review board and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Department of Radiation Oncology, Winship Cancer InstituteEmory University School of MedicineAtlantaUSA
  2. 2.Winship Cancer InstituteEmory UniversityAtlantaUSA
  3. 3.Department of Hematology and Medical OncologyEmory UniversityAtlantaUSA
  4. 4.Department of Biomedical Engineering and ChemistryEmory UniversityAtlantaUSA
  5. 5.Department of Biostatistics and BioinformaticsEmory UniversityAtlantaUSA
  6. 6.Department of Therapeutic RadiologyYale University School of MedicineNew HavenUSA

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