Journal Article

Size-Based Isolation of Circulating Tumor Cells in Lung Cancer Patients Using a Microcavity Array System

Yamamoto, Nobuyuki, Hosokawa, Masahito, Koh, Yasuhiro, Nakamura, Yukiko, Yamaguchi, Ken, Matsunaga, Tadashi, Naito, Tateaki, Tanaka, Tsuyoshi, Ono, Akira, Ono, Sachiyo, Kanbara, Hisashige, Akamatsu, Hiroaki, Takahashi, Toshiaki, Watanabe, Reiko, Kenmotsu, Hirotsugu, Murakami, Haruyasu, Yoshino, Tomoko, Shukuya, Takehito, Mori, Keita, Yoshikawa, Takayuki, Tsuya, Asuka

2013

Overview

Epithelial cell adhesion molecule (EpCAM)-based enumeration of circulating tumor cells (CTC) has prognostic value in patients with solid tumors, such as advanced breast, colon, and prostate cancer. However, poor sensitivity has been reported for non-small cell lung cancer (NSCLC). To address this problem, we developed a microcavity array (MCA) system integrated with a miniaturized device for CTC isolation without relying on EpCAM expression. Here, we report the results of a clinical study on CTCs of advanced lung cancer patients in which we compared the MCA system with the CellSearch system, which employs the conventional EpCAM-based method. Paired peripheral blood samples were collected from 43 metastatic lung cancer patients to enumerate CTCs using the CellSearch system according to the manufacturer's protocol and the MCA system by immunolabeling and cytomorphological analysis. The presence of CTCs was assessed blindly and independently by both systems. CTCs were detected in 17 of 22 NSCLC patients using the MCA system versus 7 of 22 patients using the CellSearch system. On the other hand, CTCs were detected in 20 of 21 small cell lung cancer (SCLC) patients using the MCA system versus 12 of 21 patients using the CellSearch system. Significantly more CTCs in NSCLC patients were detected by the MCA system (median 13, range 0-291 cells/7.5 mL) than by the CellSearch system (median 0, range 0-37 cells/7.5 ml) demonstrating statistical superiority (p = 0.0015). Statistical significance was not reached in SCLC though the trend favoring the MCA system over the CellSearch system was observed (p = 0.2888). The MCA system also isolated CTC clusters from patients who had been identified as CTC negative using the CellSearch system. The MCA system has a potential to isolate significantly more CTCs and CTC clusters in advanced lung cancer patients compared to the CellSearch system.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Aged, 80 and over / Antigens, Neoplasm - metabolism / Biology / Biotechnology / Breast cancer / Cancer / Carcinoma, Non-Small-Cell Lung - blood / Carcinoma, Non-Small-Cell Lung - pathology / Cell adhesion / Cell adhesion molecules / Cell Adhesion Molecules - metabolism / Cell Count / Cell Line, Tumor / Chemotherapy / Clusters / Colon / Colon cancer / Engineering / Enumeration / Epithelial Cell Adhesion Molecule / Epithelial cells / Female / Humans / Life sciences / Lung cancer / Lung diseases / Lung Neoplasms - blood / Lung Neoplasms - metabolism / Lung Neoplasms - pathology / Male / Median (statistics) / Medicine / Metastases / Metastasis / Middle Aged / Neoplastic Cells, Circulating - metabolism / Neoplastic Cells, Circulating - pathology / Non-small cell lung carcinoma / Oncology / Patients / Peripheral blood / Prognosis / Prospective Studies / Prostate / Prostate cancer / R&D / Research & development / Small Cell Lung Carcinoma - blood / Small Cell Lung Carcinoma - metabolism / Small Cell Lung Carcinoma - pathology / Solid tumors / Statistical analysis / Statistical methods / Statistics / Tissue Array Analysis - methods / Tumor cells / Tumors