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Comparative Study
. 2011 Sep 6;105(6):847-53.
doi: 10.1038/bjc.2011.294. Epub 2011 Aug 9.

A direct comparison of CellSearch and ISET for circulating tumour-cell detection in patients with metastatic carcinomas

F Farace  1 , C Massard, N Vimond, F Drusch, N Jacques, F Billiot, A Laplanche, A Chauchereau, L Lacroix, D Planchard, S Le Moulec, F André, K Fizazi, J C Soria, P Vielh
Affiliations
Comparative Study

A direct comparison of CellSearch and ISET for circulating tumour-cell detection in patients with metastatic carcinomas

F Farace et al. Br J Cancer. .

Abstract

Background: Circulating tumour cells (CTCs) can provide information on patient prognosis and treatment efficacy. However, there is no universal method to detect CTC currently available. Here, we compared the performance of two CTC detection systems based on the expression of the EpCAM antigen (CellSearch assay) or on cell size (ISET assay).

Methods: Circulating tumour cells were enumerated in 60 patients with metastatic carcinomas of breast, prostate and lung origins using CellSearch according to the manufacturer's protocol and ISET by studying cytomorphology and immunolabelling with anti-cytokeratin or lineage-specific antibodies.

Results: Concordant results were obtained in 55% (11 out of 20) of the patients with breast cancer, in 60% (12 out of 20) of the patients with prostate cancer and in only 20% (4 out of 20) of lung cancer patients.

Conclusion: Our results highlight important discrepancies between the numbers of CTC enumerated by both techniques. These differences depend mostly on the tumour type. These results suggest that technologies limiting CTC capture to EpCAM-positive cells, may present important limitations, especially in patients with metastatic lung carcinoma.

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Figures

Figure 1
Figure 1
Microscopic analysis of CTC by ISET. (A–C) Examples of isolated CTC (A, B) and of a cluster of CTC (C) detected in a patient with metastatic prostate adenocarcinoma. Circulating tumour cells were enriched using the ISET device and stained with the anti-p504S monoclonal antibody. Circulating tumour cells were identified according to the following cytomorphological criteria: (i) nuclear size equal to or larger than two pores (i.e., equal to or larger than 16 μM); (ii) the irregularity of the nuclear contour; (iii) the presence of a visible cytoplasm; (iv) a high nuclear-to-cytoplasmic ratio (>0.8). The 8 μm width pores are visible on (A–C).
Figure 2
Figure 2
Circulating tumour cells counts by CellSearch and ISET in patients with metastatic carcinomas of breast (MBC), prostate (MPC) and of lung (MLC) origin. (A) Circulating tumour cell counts by CellSearch and ISET in patients with MBC. (B) Circulating tumour cell counts by CellSearch and ISET in patients with MPC. (C) Circulating tumour cell counts by CellSearch and ISET in patients with MLC.
Figure 3
Figure 3
Classification of patients according to the numbers of CTC detected by CellSearch and ISET. (A) Classification of MBC patients according to the numbers of CTC detected by CellSearch and ISET. (B) Classification of MPC patients according to the numbers of CTC detected by CellSearch and ISET. (C) Classification of MLC patients according to the numbers of CTC detected by CellSearch and ISET. For each technique, patients with no detectable CTC were classified in group 1, patients with CTC levels ranging from 1 to 4 CTC/7.5 ml were classified in group 2 and patients with CTC levels equal or superior to 5 CTC/7.5 ml were classified in group 3.
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