Evaluation of ScreenCell® Devices for the Detection of Circulating Tumor Cells in Adrenocortical Carcinoma
Cristian Scatena, Francesca Salvianti, Pamela Pinzani, Michaela Luconi, Massimo Mannelli, Daniela Massi, Gabriella Nesi. University of Florence, Florence, Italy
Background: Circulating tumor cells (CTCs) are malignant cells found in the bloodstream that originate from the primary tumor or any metastatic localizations. Adrenocortical carcinoma (ACC) is an uncommon and heterogeneous malignancy which gains access to the systemic circulation early during disease progression. To the best of our knowledge, CTC detection rate in ACC patients has not been established. We recently validated a method for CTC detection in melanoma patients, named Isolation by Size of Epithelial Tumor cells (ISET), capable of isolating CTCs by filtration of peripheral blood through polycarbonate membranes with 8 µm pores. ScreenCell® filtration devices are novel methods of CTC isolation, based on blood filtration, which enable easy, rapid and open access to CTCs (filtration of 3 ml of peripheral blood is usually completed in approximately 2 minutes), thus avoiding the use of any dedicated instrument.
Design: CTC analysis was performed in 5 ACC patients after peripheral blood was filtered according to the manufacturer's instructions. Weiss score was between 6 and 8, with presence of venous or sinus invasion in all cases. CTC analysis was performed after surgery and in 2 cases the evaluation was also conducted previously. We applied ISET technique in one case and ScreenCell® filtration devices (ScreenCell® CY kit) in the remaining 4 cases.
Results: CTCs were isolated in all 5 (100%) patients. Hematoxylin and eosin stain of isolated CTCs retained cell morphology and were characterized by cell size >16 µm, nucleo-cytoplasmic ratio >50%, irregular nuclear shape and a hyperchromatic nucleus. Cell count number before surgery was consistent with 2.25 CTCs per ml. Similar results were obtained after treatment: 2.025 CTCs per ml were isolated after a median latency from surgery of 13 months. When the analysis was also performed prior to surgery (2 cases), no significant difference in CTC count was observed compared to that carried out after treatment (2 vs. 1.5 CTCs per ml).
Conclusions: We studied the detection of CTCs in ACC patients and demonstrated the suitability of ScreenCell® filtration devices which prove to be an easier method for CTC identification than ISET. Present results build the basis for future larger prospective studies to ascertain whether CTC analysis may be a promising diagnostic tool, providing prognostic information to guide monitoring and treatment in ACC patients.
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 48, Tuesday Afternoon