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. 2016 Jan;142(1):195-200.
doi: 10.1007/s00432-015-2021-3. Epub 2015 Jul 26.

Prevalence and number of circulating tumour cells and microemboli at diagnosis of advanced NSCLC

Mario Mascalchi  1 , Massimo Falchini  2 , Cristina Maddau  3 , Francesca Salvianti  4 , Marco Nistri  2 , Elena Bertelli  2 , Lapo Sali  2 , Stefania Zuccherelli  2 , Alessandra Vella  5 , Marzia Matucci  3 , Luca Voltolini  6 , Andrea Lopes Pegna  7 , Michaela Luconi  8 , Pamela Pinzani  4 , Mario Pazzagli  4
Affiliations

Prevalence and number of circulating tumour cells and microemboli at diagnosis of advanced NSCLC

Mario Mascalchi et al. J Cancer Res Clin Oncol. 2016 Jan.

Abstract

Purpose: Timing and magnitude of blood release of circulating tumour cells (CTC) and circulating tumour microemboli (CTM) from primary solid cancers are uncertain. We investigated prevalence and number of CTC and CTM at diagnosis of advanced non-small cell lung cancer (NSCLC).

Methods: Twenty-eight consecutive patients with suspected stage III-IV lung cancer gave consent to provide 15 mL of peripheral blood soon before diagnostic CT-guided fine-needle aspiration biopsy (FNAB). CTC and CTM (clusters of ≥3 CTC) were isolated by cell size filtration (ScreenCell), identified and counted by cytopathologists using morphometric criteria and (in 6 cases) immunostained for vimentin.

Results: FNAB demonstrated NSCLC in 26 cases. At least one CTC/3 mL blood (mean 6.8 ± 3.7) was detected in 17 (65 %) and one CTM (mean 4.5 ± 3.3) in 15 (58 %) of 26 NSCLC cases. No correlation between number of CTC or CTM and tumour type or stage was observed. Neoplastic cells from both FNA and CTC/CTM were positive for vimentin but heterogeneously.

Conclusions: CTC can be detected in two-thirds and CTM in more than half of patients with advanced NSCLC at diagnosis. Reasons underlying lack of CTC and CTM in some advanced lung cancers deserve further investigations.

Keywords: Circulating tumour cells; Circulating tumour microemboli; Non-small cell lung cancer.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Examples of neoplastic cells in fine-needle aspirates and of CTC and CTM in ScreenCell filters. a–c Case n.5. Squamous cell carcinoma stage IV. a Fine-needle aspirate (Papanicolaou staining, 40x magnification) showing a three-dimensional aggregate of cells with irregular and large nuclei. b Filter (haematoxylin and eosin staining, 40x magnification) showing a CTC with a large nucleus. c Filter (haematoxylin and eosin staining, 40x magnification) showing a CTM formed by 7 CTC. d Case n. 12. Adenocarcinoma stage IV. Filter (haematoxylin and eosin staining, 20x magnification) showing a CTM formed by 30 CTC. e–g Case n. 24. Adenocarcinoma stage IV. e Fine-needle aspirate (vimentin staining, 40x magnification) showing a cluster of tumour cells positive to vimentin. f Filter (vimentin staining, 40x magnification) showing CTC (two larger and more intensely stained nearby a pore and one smaller isolated nearby another pore) positive to vimentin. g Filter (vimentin staining, 40x magnification) showing a CTM positive to vimentin. h Case n. 22. Filter (vimentin staining, 20x magnification) showing CTC negative to vimentin. The black dots observed in b, c, d, f, g and h correspond to the 8 µm pores of the filters
See this image and copyright information in PMC

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