Cytomorphology of Circulating Tumor Cells and Cell Clusters in Chilean Patients with Colo-Rectal Cancer

Abstract

SUMMARY:The aim of this study was to determine the cytomorphological characteristics of circulating tumor cells (CTCS) in patients with colo-rectal cancer and compare them with the primary tumor and metastasis. CTCS were obtained from blood using differential gel centrifugation and detected using standard immunocytochemistry using anti-CEA. Primary CTCs were defined as those detected before surgery and secondary CTCs those detected after. Surgical specimens of the primary tumor and metastasis were evaluated using standard histological methods with hematoxillin and eosin. CTCs both primary and secondary retained the cytomorphological characteristics of the primary tumor, showing marked intra-patient pleomorphism. There were no differences between primary and secondary CTCs in their cytomorphological features. CTCs from patients with signet ring tumors showed the presence of intracellular mucin deposits. Groups of 3 or more CTCs were only seen in patients with metastasis, whereas duplets of CTcs were seen in patients with metastatic and non-metastatic colo-rectal cancer. This study provides an initial analysis of the cytomorphological features of CTCs, providing a foundation for further investigation into the significance and metastatic potential of CTCs.

Circulating Tumor Cells in Diagnosing Lung Cancer: Clinical and Morphologic Analysis

“…Our results seem to contradict the current idea that only poorly differentiated tumor cells can cross the endothelial barrier and, migrating into the blood stream, concur to the metastatic process [12]. Similarly, Marrinucci and colleagues [19] in patients having primary lung adenocarcinoma, and Murray and colleagues [13] in patients having primary colon cancer, found similar cytomorphologic features between primary tumor and CTCs. These data support the hypothesis that CTCs represent a random sampling of the many phenotypic cell types present in primary and metastatic disease and the presence of CTCs with similar morphology, as signet cells argue against the fact that only particular subsets of tumor cells (such as very poorly differentiated "stem cell like" tumor cells, or only visibly dead or apoptotic tumor cells) enter the circulation.…”

“…The CTCs, although necessary, are not sufficient for metastatic formation. The majority of CTCs dies; it has been estimated that less than 0.01% of CTCs will implant and form metastasis and most CTCs are cleared from the circulation within 24 hours [13]. Metastases do not form randomly but can form only when the seed (CTC) and the soil (target tissue) are compatible ("seed and soil" theory) [14].…”

Intratumoral morphological heterogeneity of breast cancer: neoadjuvant chemotherapy efficiency and multidrug resistance gene expression

“…It is interesting to note that tumor spheroids (microemboli) were previously detected in peripheral blood of patients with lung343536, prostate3637, renal cell38, colorectal3940, and breast41 carcinoma. In comparison with circulating single tumor cells, such tumor clusters were shown to have anoikis suppression and the highest metastatic potential35.…”