Case study of the morphologic variation of circulating tumor cells
Case study of the morphologic variation of circulating tumor cells
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DOI：
10.1016/j.humpath.2006.08.027
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发表时间：
2007-03-01
期刊：
影响因子：
3.3
通讯作者：
Kuhn, Peter
中科院分区：
文献类型：
--
作者：
Marrinucci, Dena;Bethel, Kelly;Kuhn, Peter
我们报告了广泛转移性乳腺癌循环成分的详细细胞形态评估。一名此前健康的38岁女性被诊断出患有乳腺癌。广泛的局部切除显示一个1.7 cm的浸润性导管腺癌，BSR评分7/9伴血管淋巴侵犯，4/20个淋巴结癌阳性。五年后，骨髓活检显示转移性乳腺癌累及骨髓，此后不久，发现肝和肺门有转移。她参加了一项检测乳腺癌循环肿瘤细胞(CTCs)的临床研究。使用针对细胞角蛋白的免疫荧光方案在10毫升的血液样本中鉴定了总共659个CTCs，并使用光纤阵列扫描技术进行了检测。随后用Wright-Giemsa染色对检测到的CTCs进行染色，并在光学显微镜下对代表性细胞进行详细的形态评价。我们发现患者的CTCs表现出高度的多形性，包括具有高和低核浆比的CTC，以及表现出早期和晚期的凋亡变化的CTC。此外，与其他部位的肿瘤细胞相比，原发和转移肿瘤中存在的癌细胞的完整形态谱也存在于外周血液循环中。(C)2007 Elsevier Inc.保留所有权利。
We report a detailed cytomorphologic evaluation of the circulating component of widely metastatic breast carcinoma. A previously healthy 38-year-old woman was diagnosed with breast cancer. Wide local excision revealed a 1.7-cm infiltrating ductal adenocarcinoma, BSR score 7/9 with angiolymphatic invasion, and 4/20 lymph nodes positive for carcinoma. Five years later, a bone marrow biopsy revealed involvement of bone marrow by metastatic breast carcinoma, and shortly thereafter, metastases were identified in the liver and lung hilum. She enrolled in a clinical investigation for the detection of circulating tumor cells (CTCs) in breast carcinoma. A total of 659 CTCs were identified in a 10-mL blood sample using an immumofluorescent protocol targeting cytokeratins and detected using fiber-optic array scanning technology. The detected CTCs were subsequently stained with a Wright-Giemsa stain, and representative cells were evaluated in detail by light microscopy for morphologic evaluation. We find that the patient's CTCs exhibit a high degree of pleomorphism including CTCs with high and low nuclear-to-cytoplasmic ratios along with CTCs exhibiting early and late apoptotic changes. In addition, in comparison with her tumor cells in other sites, the full morphologic spectrum of cancer cells present in primary and metastatic tumor is also present in peripheral blood circulation. (c) 2007 Elsevier Inc. All rights reserved.