Monitoring disease progression and treatment efficacy with circulating tumor cells in esophageal squamous cell carcinoma: A case report

Table 1 Relationship between the number of circulating tumor cells in the peripheral blood and disease progression

Code	Time	Number of CTCs/7.5 mL	Results of the imaging study	Serum tumor marker levels	Disease progression	Treatment
Pre	Preoperative 2 d	1	CT revealed wall thickening of the mid-lower esophagus, with a high likelihood of esophageal carcinoma	Normal levels of CA125, CA15-3, CA19-9, CA242, AFP, CEA, HGH‚ PSA, f-PSA, β-HCG, NSE and FER	Preoperative diagnosis of poorly differentiated squamous cell carcinoma	Surgical treatment
Post 1	Postoperative 1 wk	14		CEA 2.4 ng/mL; AFP 1.7 ng/mL	Tumor resection, lymph node dissection	Postoperative chemotherapy started
Post 2	Postoperative 12 wk	84	Bone imaging revealed an abnormal increase in salt metabolism in the 10th left front rib	Normal levels of CA125, CA15-3, CA19-9, CA242, AFP, CEA, HGH‚ PSA, f-PSA, β-HCG, NSE and FER	Subcutaneous metastasis and bone metastasis	Treatment by a systemic γ-knife with a boost dose and chemotherapy
Post 3	Postoperative 48 wk	21	CT revealed occupying nodules in the lower right lobe, suggesting metastatic cancer	CEA 2.0 ng/mL; AFP 1.5 ng/mL	Right lung metastasis	Treatment with a localized γ-knife and chemotherapy
Post 4	Postoperative 55 wk	15		CEA 2.2 ng/mL; AFP 1.2 ng/mL	Stable condition	Systemic chemotherapy
Post 5	Postoperative 104 wk	41	PET-CT revealed a high density of radionuclide in the esophageal residue, suggesting disease recurrence	Normal levels of CA125, CA15-3, CA19-9, CA242, AFP, CEA, HGH‚ PSA, f-PSA, β-HCG, NSE and FER	Recurrence	Systemic chemotherapy
Post 6	Postoperative 117 wk	14		CEA 2.1 ng/mL	Disease in progression	Chemotherapy with Chinese medicine
Post 7	Postoperative 178 wk	14		CEA 2.4 ng/mL	Disease in progression	Chemotherapy with Chinese medicine
Post 8	Postoperative 186 wk	5		CEA 0.5 ng/mL	Condition improved	Chinese medicine
Post 9	Postoperative 196 wk	3			Stable condition	Adjuvant treatment with traditional Chinese medicine
Post 10	Postoperative 207 wk	0			Stable condition	Adjuvant treatment with traditional Chinese medicine
Post 11	Postoperative 222 wk	1			Stable condition	Adjuvant treatment with traditional Chinese medicine
Post 12	Postoperative 238 wk	1 (suspicious)		Normal levels of CA125, CA15-3, CA19-9, CA242, AFP, CEA, HGH‚ PSA, f-PSA, β-HCG, NSE and FER	Stable condition	Adjuvant treatment with traditional Chinese medicine
Post 13	Postoperative 262 wk	0			Stable condition	Adjuvant treatment with traditional Chinese medicine
Post 14	Postoperative 300 wk	0			Stable condition	Adjuvant treatment with traditional Chinese medicine

CTCs: Circulating tumor cells; AFP: α-fetoprotein; CEA: Carcinoembryonic antigen; NSE: Neuron-specific enolase; FER: Ferritin; HGH: Human growth hormone; β-HCG: β-human chorionic gonadotropin; f-PSA: Free-prostate specific antigen; CT: Computed tomography.