Circulating tumor cells in blood as a prognostic biomarker in tongue squamous cell carcinoma

Objective. The study aimed to evaluate the role of circulating tumor cells (CTCs) as a prognostic biomarker of tongue squamous cell carcinoma (TSCC). Study Design. CTC levels in the peripheral blood of 50 patients with TSCC at baseline (i.e., before treatment) and of 8 healthy donors were determined using the NanoVelcro system. The relationship between CTC levels and clinicopathologic parameters and clinical outcomes such as recurrence, metastasis, and death during follow-up (mean 17 months) was analyzed. Results. CTCs levels were closely correlated with TSCC clinical staging (P =.002), N staging (P =.007), and progression status (P =.002) in TSCC patients. Receiver operating characteristic (ROC) analysis revealed that the count of CTC >= 4 (area under curve: 0.832 [95% confidence interval 0.695-0.950]; sensitivity: 0.83; specificity: 0.75; P <.001) was a better prognostic marker than TNM stage (area under curve: 0.692 [0.536-0.848]; sensitivity: 0.83; specificity: 0.55; P =.023). In addition, univariate and multivariate analysis showed that the CTC was an important and independent predictive factor for overall survival and disease-free survival (P <.001). Conclusions. CTC was an independent prognostic indicator in patients with TSCC. CTC may be used as an auxiliary parameter to predict the prognosis of TSCC.