Detection of circulating pancreas epithelial cells in patients with pancreatic cystic lesions

Abstract

Hematogenous dissemination is thought to be a late event in cancer progression. We recently showed in a genetic model of pancreatic ductal adenocarcinoma that pancreas cells can be detected in the bloodstream before tumor formation. To confirm these findings in humans, we used microfluidic geometrically enhanced differential immunocapture to detect circulating pancreas epithelial cells in patient blood samples. We captured more than 3 circulating pancreas epithelial cells/mL in 7 of 21 (33%) patients with cystic lesions and no clinical diagnosis of cancer (Sendai criteria negative), 8 of 11 (73%) with pancreatic ductal adenocarcinoma, and in 0 of 19 patients without cysts or cancer (controls). These findings indicate that cancer cells are present in the circulation of patients before tumors are detected, which might be used in risk assessment.

Keywords: Circulating Tumor Cells; Early Detection; IPMN; Pancreatic Cancer.

Figure 1. Detection of CECs in patients using GEDI

(A) Depiction of the GEDI device. (B) Vertical scatterplots of CEC concentrations (per ml blood) for Cancer-Free patients (Control), patients with cystic lesions of the pancreas without dysplasia or tumor (Cystic Lesion) and patients with PDAC. Lines indicate means. Bars indicate statistically significant differences by Mann-Whitney test. Representative images of individual GEDI-captured nucleated cells from (C) control human blood spiked with PI34 cells and (D) blood from a patient with PDAC. Cells were stained for CD45 (green), Pdx-1 (red) and DNA (DAPI, blue). Scale bar, 20µm.