{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:27:32Z","timestamp":1789950452380,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T00:00:00Z","timestamp":1488499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R25CA092203"],"award-info":[{"award-number":["R25CA092203"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA169086"],"award-info":[{"award-number":["R01CA169086"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Circulating epithelioid cells (CECs), also known as circulating tumor, circulating cancer, circulating epithelial, or circulating nonhematologic cells, are a prognostic factor in various malignancies that can be isolated via various protocols. In the current study, the authors analyzed the cytomorphologic characteristics of CECs isolated by size in a cohort of patients with benign and malignant pancreatic diseases to determine whether cytomorphological features could predict CEC origin.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Blood samples were collected from 9 healthy controls and 171 patients with pancreatic disease who were presenting for surgical evaluation before treatment. Blood was processed with the ScreenCell size\u2010based filtration device. Evaluable CECs were analyzed in a blinded fashion for cytomorphologic characteristics, including cellularity; nucleoli; nuclear size, irregularity, variability, and hyperchromasia; and nuclear\u2010to\u2010cytoplasmic ratio. Statistical differences between variables were analyzed via the Fisher exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>No CECs were identified among the 9 normal healthy controls. Of the 115 patients with CECs (positive or suspicious for), 25 had nonmalignant disease and 90 had malignancy. There were no significant differences in any of the cytologic criteria noted between groups divided by benign versus malignant, neoplastic versus nonneoplastic, or pancreatic ductal adenocarcinoma versus neuroendocrine tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>CECs were observed in patients with malignant and nonmalignant pancreatic disease, but not in healthy controls. There were no morphologic differences observed between cells from different pancreatic diseases, suggesting that numerous conditions may be associated with CECs in the circulation and that care must be taken not to overinterpret cells identified by cytomorphology as indicative of circulating tumor cells of pancreatic cancer. Additional studies are required to determine the origin and clinical significance of these cells. <jats:bold><jats:italic>Cancer Cytopathol<\/jats:italic> 2017;125:332\u2013340.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21841","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T08:56:37Z","timestamp":1488531397000},"page":"332-340","source":"Crossref","is-referenced-by-count":31,"title":["Cytologic characteristics of circulating epithelioid cells in pancreatic disease"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-6538","authenticated-orcid":false,"given":"Matthew W.","family":"Rosenbaum","sequence":"first","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy E.","family":"Cauley","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birte","family":"Kulemann","sequence":"additional","affiliation":[{"name":"Department of Surgery University Hospital Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Liss","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Fernandez\u2010del","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L.","family":"Warshaw","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D.","family":"Lillemoe","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah P.","family":"Thayer","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Department of Surgery, University of Nebraska Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha B.","family":"Pitman","sequence":"additional","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,3]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"146","article-title":"A case of cancer in which cells similar to those in the tumours were seen in the blood after death","volume":"14","author":"Ashworth TR","year":"1869","journal-title":"Aust Med J."},{"key":"e_1_2_8_3_1","unstructured":"US Food and Drug Administration.CellSearch\u2122 Epithelial Cell Kit\/CellSpotter\u2122 Analyzer\u2010K03158.http:\/\/www.fda.gov\/MedicalDevices\/ProductsandMedicalProcedures\/DeviceApprovalsandClearances\/Recently\u2010ApprovedDevices\/ucm081239.htm. 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