Clinical Significance for Risk Stratification of Papillary Thyroid Cancer by TUMORFISHER Circulating Tumor Cell Technique

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 (CTC) as a noninvasive 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 with regard to 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