Abstract
Circulating tumor cells (CTCs) in tumor draining vein blood (DB) are potential sources for liquid biopsy. However, the identification of CTCs in DB of breast cancer has not been attempted. In this study, we investigated the feasibility of CTC detection in DB of breast cancer patients using a newly developed filtration-based microfluidic CTC detection device. Samples of peripheral vein blood (PB) and DB drawn from the lateral thoracic vein of the resected breast tissue were collected during the perioperative period. We investigated 41 breast cancer patients who underwent breast surgery with axillary lymph node dissection. DB was successfully collected in 36 patients (87.8%), with a mean amount of 0.85 ml. CTCs were detected in 58.3% of PB samples and 80.6% of DB samples. DB had significant higher number of CTCs compared with PB (p < 0.001). CTCs were detected in 75.0% of DB samples and 50.0% of PB samples from patients achieving pathological complete response after neoadjuvant chemotherapy. These results suggest that abundant CTCs are released into the DB of breast cancer patients, indicating that CTCs in DB would be alternative sources for liquid biopsy and potential indicators for monitoring of treatment response and prognosis in breast cancer patients.
Highlights
To address these issues, we conducted a pilot study to evaluate the feasibility and utility of circulating tumor cells (CTCs) analysis in draining vein blood (DB) of breast cancer patients with or without neoadjuvant chemotherapy, using our recently developed filtration-based microfluidic CTC detection device[25]
We examined CTCs in peripheral vein blood (PB) collected one day before or just before surgery and in DB drawn from the lateral thoracic vein (LTV) of the resected breast tissues immediately after resection
We report that abundant CTCs were detected from DB of breast cancer patients compared with PB, and discuss the potential usefulness of CTCs in DB as a liquid biopsy assay in patients with breast cancer
Summary
The device contains a 3- dimensional (3D) metal filter that can trap CTCs based on size, after which we can cytologically detect CTCs using glass slide specimens stained by Papanicolau (Pap), immunocytochemistry (ICC), and immunofluorescence (IF) under light microscopy[25,26,27]. This system can isolate CTCs even in a small volume of blood sample and allow cytological evaluation of CTCs in permanent specimens that are difficult to observe by immunofluorescence microscopy under dark field conditions[26]. We report that abundant CTCs were detected from DB of breast cancer patients compared with PB, and discuss the potential usefulness of CTCs in DB as a liquid biopsy assay in patients with breast cancer
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