Detection of Circulating Tumor Cells (CTCs) in Patients Undergoing Surgery for Non-Small Cell Lung Cancer (NSCLC). A Pilot Study Comparing an Indirect Technique, the CellSearch System, and a Cytomorphological Approach, the Isolation by Size of Epithelial Tumor Cells Method
V Hofman, E Long, M Ilie, E Selva, C Bonnetaud, V Lespinet, T Molina, P Viehl, S Lantuejoul, J Mouroux, P Paterlini-Brechot, P Hofman. CHU Nice, Nice, France; Hôtel Dieu, Paris, France; IGR, Paris, France; CHU Michallon, Grenoble, France; Université ParisV, Paris, France
Background: Despite recent advances in the management of patients developing NSCLC, the cure rate of these patients remains low. The prognosis is largely determined by the occurrence of distant metastases. This relapse can be mainly caused by clinically occult micrometastasis present at primary diagnosis. In this regard, early detection of circulating tumor cells (CTCs) before surgery might help to improve therapeutic strategy. Currently, there is a lack of data comparing direct and indirect methods for CTCs detection performed from the same cohort of patients undergoing surgery for NSCLC. We have conducted this study to look for the presence of CTCs in peripheral blood of patients with NSCLC before surgery by using an indirect method of detection, the CellSearch (CS) system (Veridex), and a direct method of detection, the Isolation by Size of Epithelial Tumor (ISET) cells technology (Metagenex).
Design: A total of 114 consecutive patients undergoing surgery for NSCLC and 30 healthy individuals were included in this study. Presence of CTCs was evaluated at the same time by the CS (using the CellSearch Epithelial Cell Kit) and by the ISET [using a double immunolabeling with anti-pan-cytokeratin (KL1) and anti-vimentin antibodies] technologies.
Results: CTCs were detected in 73/114 (64%) patients using CS and/or ISET. CTCs were detected in 30/114 (26%) and in 62 /114 (54%) patients using ISET and CS, respectively. 19/114 patients (17%) showed CTCs detected both by CS and ISET. However, 18/114 patients (16%) had vimentin positive cells of uncertain origin detected by ISET method only. The presence and the number of CTCs detected by these 2 methods was independent of the pTNM staging and the histological subtypes. Subjects of the control group had no positive individual detected by ISET and by CS.
Conclusions: When using CS and ISET methods, CTCs can be detected before radical surgery in NSCLC patients in a high number of cases. However, only 17% of NSCLC patients had simultaneous detection of CTCs by ISET and CS, underlying that these two methods could be complementaries to detect CTCs preoperatively in NSCLC.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 247, Tuesday Morning