Abstract
ObjectiveThe study set out to assess the feasibility of using ParsortixTM circulating tumour cell (CTC) extraction and CytoFoam Disc cell‐block immunohistochemistry to diagnose metastatic carcinoma from blood samples in a National Health Service district general hospital.MethodsBlood samples were taken from 50 patients with metastatic carcinoma and 50 healthy volunteers and processed, using a previously published method, to extract CTCs and collect them in a cell‐block for routine formalin‐fixed paraffin sectioning and immunohistochemistry. The extracted cells were compared with the patients’ routine diagnostic samples.ResultsThe samples from the 50 carcinoma patients showed cytokeratin‐positive cells in 19 cases. In eight of these, the cytokeratin‐positive cells had a similar immunoprofile to the carcinoma in the conventional biopsy or cytology specimen. Some carcinoma patients also had circulating cytokeratin‐positive cells that were probably benign epithelial cells and circulating megakaryocytes. Both of these types of cells were also found in healthy volunteers. Processing and initial examination could be completed in 2 days. The full processing cost was approximately £316 per case.ConclusionsCTCs could be extracted from the blood of some patients with metastatic carcinoma and formed into a formalin‐fixed cell‐block for routine paraffin processing and immunohistochemistry. The specificity of this approach is constrained by the observation that some patients with metastatic carcinoma had circulating cytokeratin‐positive cells that were probably benign, and these were also found in healthy volunteers. Circulating megakaryocytes were present in carcinoma patients and healthy volunteers.
Highlights
There is currently a lot of interest in circulating tumour cells (CTCs), and their potential in liquid-based tumour diagnosis
The reason for the change from 10 mL to 20 mL was the discovery of probable neoplastic circulating cytokeratin-positive cells (NCCCs) and megakaryocytes in the early samples and it was decided that an additional 10 mL of blood should be taken for ParsortixTM extraction and cytological examination
The study set out to assess the feasibility of using this method to diagnose metastatic carcinoma
Summary
There is currently a lot of interest in circulating tumour cells (CTCs), and their potential in liquid-based tumour diagnosis. In this context, a CTC usually refers to a circulating cell from a solid tumour, such as a carcinoma, melanoma or sarcoma, and haematological malignancies are excluded. Most recent studies have concentrated on extracting and analysing neoplastic circulating epithelial cells, with the aim of developing techniques to diagnose and characterise carcinomas. We described a method for preparing a cell-block from a very sparsely cellular extract of CTCs and other rare circulating cells, and examining the cells with routine diagnostic methods including formalin-fixed paraffin sections and immunohistochemistry.[7]. We focused on the type of rare circulating cells recovered, quality of preservation, concordance with the associated diagnostic sample, turn-around times and cost
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