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Circulating Tumor Cells Count and Morphological Features in Breast,Colorectal and Prostate Cancer
Authors:Sjoerd T Ligthart  Frank A W Coumans  Francois-Clement Bidard  Lieke H J Simkens  Cornelis J A Punt  Marco R de Groot  Gerhardt Attard  Johann S de Bono  Jean-Yves Pierga  Leon W M M Terstappen
Institution:1. Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, The Netherlands.; 2. Department of Medical Oncology, Institut Curie, Paris, France.; 3. Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.; 4. Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.; 5. The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom.; National Cancer Center, Japan,
Abstract:

Background

Presence of circulating tumor cells (CTC) in patients with metastatic breast, colorectal and prostate cancer is indicative for poor prognosis. An automated CTC (aCTC) algorithm developed previously to eliminate the variability in manual counting of CTC (mCTC) was used to extract morphological features. Here we validated the aCTC algorithm on CTC images from prostate, breast and colorectal cancer patients and investigated the role of quantitative morphological parameters.

Methodology

Stored images of samples from patients with prostate, breast and colorectal cancer, healthy controls, benign breast and colorectal tumors were obtained using the CellSearch system. Images were analyzed for the presence of aCTC and their morphological parameters measured and correlated with survival.

Results

Overall survival hazard ratio was not significantly different for aCTC and mCTC. The number of CTC correlated strongest with survival, whereas CTC size, roundness and apoptosis features reached significance in univariate analysis, but not in multivariate analysis. One aCTC/7.5 ml of blood was found in 7 of 204 healthy controls and 9 of 694 benign tumors. In one patient with benign tumor 2 and another 9 aCTC were detected.

Significance of the study

CTC can be identified and morphological features extracted by an algorithm on images stored by the CellSearch system and strongly correlate with clinical outcome in metastatic breast, colorectal and prostate cancer.
Keywords:
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