bromochloroacetic-acid and Embolism

Circulating tumor microemboli (CTM) are potentially important cancer biomarkers, but using them for cancer detection in early-stage disease has been assay limited. We examined CTM test performance using a sensitive detection platform to identify stage I non-small-cell lung cancer (NSCLC) patients undergoing imaging evaluation.. First, we prospectively enrolled patients during 18F-FDG PET-CT imaging evaluation for lung cancer that underwent routine phlebotomy where CTM and circulating tumor cells (CTCs) were identified in blood using nuclear (DAPI), cytokeratin (CK), and CD45 immune-fluorescent antibodies followed by morphologic identification. Second, CTM and CTC data were integrated with patient (age, gender, smoking, and cancer history) and imaging (tumor diameter, location in lung, and maximum standard uptake value [SUVmax]) data to develop and test multiple logistic regression models using a case-control design in a training and test cohort followed by cross-validation in the entire group.. We examined 104 patients with NSCLC, and the subgroup of 80 with stage I disease, and compared them to 25 patients with benign disease. Clinical and imaging data alone were moderately discriminating for all comers (Area under the Curve [AUC] = 0.77) and by stage I disease only (AUC = 0.77). However, the presence of CTM combined with clinical and imaging data was significantly discriminating for diagnostic accuracy in all NSCLC patients (AUC = 0.88, p value = 0.001) and for stage I patients alone (AUC = 0.87, p value = 0.002).. CTM may add utility for lung cancer diagnosis during imaging evaluation using a sensitive detection platform.

Topics: Aged; Aged, 80 and over; Area Under Curve; Biomarkers, Tumor; Carcinoma, Non-Small-Cell Lung; Embolism; Female; Fluorodeoxyglucose F18; Humans; Indoles; Keratins; Leukocyte Common Antigens; Lung Neoplasms; Male; Middle Aged; Multimodal Imaging; Neoplasm Staging; Neoplastic Cells, Circulating; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Risk Assessment; Tomography, X-Ray Computed; Tumor Burden

77 formalin-fixed and paraffin-embedded mammary carcinomas and the regional lymph nodes of bitches were examined by immunocytochemical technique, all of them free of metastases in routine HE-staining. To compare the two methods, two serial sections were cut of three parts of the lymph nodes. One was used for incubation with the antibody AE1, which reacts with cytokeratin subtype I/A, the other for staining with HE. From 60 of the 77 bitches we received information about the operation and the follow up study period (surgical method, new tumours, survival rate and causes of death). These data were compared with the immunocytochemical results of the lymph nodes. In 84.4% of all 77 lymph nodes tumour cell embolism and/or micrometastases were detected. Comparing the two methods, we found that with HE-staining it was only possible to detect two thirds of all micrometastases containing more than 50 tumor cells. Smaller micrometastases were suspicious in a few cases, the majority could not be detected at all. In the follow up study there was evidence of a better prognosis for bitches with tumours detected in an early stage of growth and treated with radical mastectomy. This was independent of a positive or negative result of tumour cells in lymph nodes. The presence of cancer cells in lymph nodes was only important, if either the tumour was treated in an advanced stage or only single complexes or tumour nodes were extirpated. These dogs often showed metastases in the lung.

Topics: Animals; Antibodies; Cause of Death; Dog Diseases; Dogs; Embolism; Female; Follow-Up Studies; Immunohistochemistry; Keratins; Lymphatic Metastasis; Mammary Neoplasms, Animal; Mastectomy, Radical; Predictive Value of Tests; Survival Rate; Time Factors