Tumor Cells in Blood Indicate Poor Cancer Prognosis

A technique to separate circulating tumor cells in the blood of patients with squamous cell cancer of the head and neck (SCCHN) has been developed.

Circulating tumors cells (CTCs) can be isolated from whole blood after removal of the red cells by lysis and leucocytes by negative depletion and identified by fluorescent immunostaining.

Investigators at the Ohio State University, (Columbus, OH, USA), were able to identify CTCs in the blood of patients with squamous cell otolaryngeal carcinoma. This study involves 48 patients who underwent surgical intervention for squamous cell cancer of the head and neck, 35 of which had smoked the equivalent of a pack of cigarettes a day for 15 years, and half of them were moderate to heavy alcohol consumers.

The scientists eliminated all the red blood cells by rupturing them, then removed the healthy white blood cells by labeling them using anti-CD45, tetrameric antibody complex, (TAC; Stem Cell Technologies, Vancouver, Canada), and dextran-coated magnetic nanoparticles. The immunomagnetically labeled cells were then passed through the optimized magnetic deposition sorting system to deplete a majority of the peripheral blood leukocytes and obtain an enriched sample containing the CTCs. The enriched sample containing the suspended CTCs was then divided into multiple aliquots. One of the aliquots was subjected to a cytospin for immunocytochemistry staining, and a second aliquot was lysed to obtain RNA for further molecular analysis.

The study showed that the visually confirmed presence of CTCs in the peripheral blood of patients with SCCHN, using a high-performance negative depletion technique, was predictive of disease recurrence and/or cancer-related mortality. The absence of CTCs was possibly a promising indicator for disease-free survival and continued prospective follow-up on these patient outcomes was recommended.

Squamous cell carcinomas make up 95% of the 36,500 new cases of head and neck cancer expected to occur in the United States in 2010, with an estimated 7,900 deaths from the disease. Currently, no prognostic blood test exists for this malignancy.

Kris J. Jatana, MD, the lead author of the study said, "In the future, along with continued follow-up of these patients, we want to further characterize these cells and determine if this technology can be used for early detection of cancer recurrence. This could help us individualize treatment and optimize outcomes for head and neck cancer patients." The study was published in December 2010, in the Archives of Otolaryngology, Head and Neck Surgery.

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