What question did this study set out to answer?

This study aims to assess the utility of circulating tumor cells for preoperative risk stratification in papillary thyroid cancer patients.

January 18, 2026Open Access

Clinical Significance for risk stratification of papillary thyroid cancer by TUMORFISHER circulating tumor cells technique

Key Points

This study aims to assess the utility of circulating tumor cells for preoperative risk stratification in papillary thyroid cancer patients.
Conducted a prospective study evaluating preoperative CTC levels in 210 patients with PTC
Developed a dual-threshold model to assess diagnostic performance
Focused on the Papillary Thyroid Microcarcinoma subgroup (n=100) to address treatment uncertainties
Monitored patients over a median follow-up of 44 months for progression-free survival
Analyzed cutoff values for CTC counts to determine high-risk and low-risk patients.
A cutoff of ≥ 2 CTCs identified high-risk patients with 93.2% specificity and 88.2% positive predictive value
In the PTMC cohort, CTC count < 2 identified low-risk patients with 94.0% negative predictive value
CTC-negative patients showed improved progress-free survival, particularly in the PTMC subgroup with significantly longer PFS
CTC-positive cases had a hazard ratio of 0.035 for recurrence compared to CTC-negative cases.

Abstract

Abstract Purpose: Preoperative risk stratification for papillary thyroid cancer (PTC) is a significant clinical challenge, as current systems primarily rely on postoperative pathology, limiting their utility for initial treatment planning. This study aimed to evaluate the effectiveness of using circulating tumor cells (CTCs) as a non-invasive liquid biopsy tool to stratify patient risk preoperatively. Experimental Design: We conducted a prospective study evaluating preoperative CTC levels in 210 patients diagnosed with PTC. A dual-threshold model was developed to analyze the diagnostic performance of CTC counts. The study particularly focused on the Papillary Thyroid Microcarcinoma (PTMC) subgroup (n=100) to address clinical uncertainty regarding active surveillance versus definitive therapy. Patients were monitored over a median follow-up period of 44 months to assess progression-free survival (PFS) and long-term prognostic outcomes. Results: The dual-threshold model demonstrated excellent diagnostic performance. A cutoff of ≥ 2 CTCs effectively identified high-risk patients with 93.2% specificity and 88.2% positive predictive value (PPV). In the PTMC cohort, a CTC count 2 reliably identified low-risk patients suitable for active surveillance (NPV=94.0%), while a count ≥ 2 pinpointed those with high-risk features warranting surgery (Specificity=96.4%, PPV=80.0%). Prognostic analysis revealed that CTC-negative patients had improved PFS. This was most significant in the PTMC subgroup, where the CTC-negative cohort remained recurrence-free and showed significantly longer PFS compared to CTC-positive cases (HR=0.035, 95% CI: 0.002-0.726; P=0.030). Conclusions: Preoperative CTC detection enables precise risk stratification for PTC patients. This liquid biopsy approach allows clinicians to personalize therapy—confidently selecting conservative management for low-risk individuals and recommending aggressive treatment for high-risk patients—thereby optimizing clinical decision-making and long-term outcomes.

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Cite This Study

Jiang et al. (Fri,) studied this question.

synapsesocial.com/papers/696c79cde45ebfc9113cd3d9 https://doi.org/https://doi.org/10.1158/1078-0432.ccr-25-2694

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