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Development of a new method for identification and quantification in cerebrospinal fluid of malignant cells from breast carcinoma leptomeningeal metastasis.

Le Rhun E, Massin F, Tu Q, Bonneterre J, Bittencourt Mde C, Faure GC - BMC Clin Pathol (2012)

Bottom Line: The diagnosis of leptomeningeal metastasis (LM) in patients with solid tumors remains difficult.EpCAM+/cytokeratin + cells with typical morphology could be observed and enumerated sequentially with reproducible results in low or elevated numbers in 8 patients.This methodology, established on a limited volume of sample and allowing delayed processing, could prove of great interest in the diagnosis and follow-up of cancer patients with LM, especially to appreciate the efficacy of chemotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurology, Breast Unit, Deparment of Medical Oncology, Oscar Lambret Center, Lille, France and Neuro-oncology, University Hospital, Lille, France. E-lerhun@o-lambret.fr.

ABSTRACT

Background: The diagnosis of leptomeningeal metastasis (LM) in patients with solid tumors remains difficult. The usual diagnostic methods of cytomorphological assessment of cerebro-spinal fluid (CSF) and gadolinium enhanced MRI of the entire neuraxis lack both specificity and sensitivity. The Veridex CellSearch® technology has been designed for the detection of circulating tumor cells (CTC) in blood from cancer patients and validated for the follow-up and prognosis of breast, prostate, colorectal, and lung cancer. Our aim was to adapt this technology for the detection and the enumeration of tumor cells in the CSF of breast cancer patients presenting with LM.

Methods: On the occasion of a randomized phase III study evaluating the role of the intrathecal treatment in LM from breast cancer (DEPOSEIN, EudraCT N°: 2010-023134-23), the CellSearch® technology was adapted to direct enrichment, enumeration and visualization of tumor cells in 5 mL CSF samples, collected on CellSave® Preservative Tubes and analyzed within 3 days after CSF sampling.

Results: Sixteen CSF of 8 patients with primary breast cancer presenting with LM were studied. EpCAM+/cytokeratin + cells with typical morphology could be observed and enumerated sequentially with reproducible results in low or elevated numbers in 8 patients.

Conclusion: This methodology, established on a limited volume of sample and allowing delayed processing, could prove of great interest in the diagnosis and follow-up of cancer patients with LM, especially to appreciate the efficacy of chemotherapy.

No MeSH data available.


Related in: MedlinePlus

Collection of validated images of tumor cells (EpCAM+/cytokeratin + cells with a DAPI-stained nucleus and no CD45 staining) detected in the CSF from a patient with LM secondary to breast cancer.
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Figure 1: Collection of validated images of tumor cells (EpCAM+/cytokeratin + cells with a DAPI-stained nucleus and no CD45 staining) detected in the CSF from a patient with LM secondary to breast cancer.

Mentions: The first part of the translational study was to adapt the CellSearch® technology for the detection and enumeration of tumor cells in the CSF of breast cancer LM. Sixteen CSF samples were available for the evaluation of the innovative method: These samples are described in Table 2. All CSF samples were obtained at lumbar site and analysed at LM diagnosis or at different times during LM treatment. Malignant cells were observed at cytomorphological analysis in 12 samples, and in 14 samples with the CellSearch® technology, with tumor cells numbers ranging between 1 and 10500 /5 mL. Figure 1 shows representative epithelial tumour cells detected in CSF from one breast cancer patient by CellSearch® technology. These cells have similar aspects to epithelial tumour cells described in blood as CTC from breast cancer patients [17]. Figure 2 summarizes quantitative results of tumor cells in CSF by CellSearch® technology.


Development of a new method for identification and quantification in cerebrospinal fluid of malignant cells from breast carcinoma leptomeningeal metastasis.

Le Rhun E, Massin F, Tu Q, Bonneterre J, Bittencourt Mde C, Faure GC - BMC Clin Pathol (2012)

Collection of validated images of tumor cells (EpCAM+/cytokeratin + cells with a DAPI-stained nucleus and no CD45 staining) detected in the CSF from a patient with LM secondary to breast cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539901&req=5

Figure 1: Collection of validated images of tumor cells (EpCAM+/cytokeratin + cells with a DAPI-stained nucleus and no CD45 staining) detected in the CSF from a patient with LM secondary to breast cancer.
Mentions: The first part of the translational study was to adapt the CellSearch® technology for the detection and enumeration of tumor cells in the CSF of breast cancer LM. Sixteen CSF samples were available for the evaluation of the innovative method: These samples are described in Table 2. All CSF samples were obtained at lumbar site and analysed at LM diagnosis or at different times during LM treatment. Malignant cells were observed at cytomorphological analysis in 12 samples, and in 14 samples with the CellSearch® technology, with tumor cells numbers ranging between 1 and 10500 /5 mL. Figure 1 shows representative epithelial tumour cells detected in CSF from one breast cancer patient by CellSearch® technology. These cells have similar aspects to epithelial tumour cells described in blood as CTC from breast cancer patients [17]. Figure 2 summarizes quantitative results of tumor cells in CSF by CellSearch® technology.

Bottom Line: The diagnosis of leptomeningeal metastasis (LM) in patients with solid tumors remains difficult.EpCAM+/cytokeratin + cells with typical morphology could be observed and enumerated sequentially with reproducible results in low or elevated numbers in 8 patients.This methodology, established on a limited volume of sample and allowing delayed processing, could prove of great interest in the diagnosis and follow-up of cancer patients with LM, especially to appreciate the efficacy of chemotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurology, Breast Unit, Deparment of Medical Oncology, Oscar Lambret Center, Lille, France and Neuro-oncology, University Hospital, Lille, France. E-lerhun@o-lambret.fr.

ABSTRACT

Background: The diagnosis of leptomeningeal metastasis (LM) in patients with solid tumors remains difficult. The usual diagnostic methods of cytomorphological assessment of cerebro-spinal fluid (CSF) and gadolinium enhanced MRI of the entire neuraxis lack both specificity and sensitivity. The Veridex CellSearch® technology has been designed for the detection of circulating tumor cells (CTC) in blood from cancer patients and validated for the follow-up and prognosis of breast, prostate, colorectal, and lung cancer. Our aim was to adapt this technology for the detection and the enumeration of tumor cells in the CSF of breast cancer patients presenting with LM.

Methods: On the occasion of a randomized phase III study evaluating the role of the intrathecal treatment in LM from breast cancer (DEPOSEIN, EudraCT N°: 2010-023134-23), the CellSearch® technology was adapted to direct enrichment, enumeration and visualization of tumor cells in 5 mL CSF samples, collected on CellSave® Preservative Tubes and analyzed within 3 days after CSF sampling.

Results: Sixteen CSF of 8 patients with primary breast cancer presenting with LM were studied. EpCAM+/cytokeratin + cells with typical morphology could be observed and enumerated sequentially with reproducible results in low or elevated numbers in 8 patients.

Conclusion: This methodology, established on a limited volume of sample and allowing delayed processing, could prove of great interest in the diagnosis and follow-up of cancer patients with LM, especially to appreciate the efficacy of chemotherapy.

No MeSH data available.


Related in: MedlinePlus