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Circulating tumor cells and microemboli can differentiate malignant and benign pulmonary lesions.
- Source :
-
Journal of Cancer [J Cancer] 2017 Jul 15; Vol. 8 (12), pp. 2223-2230. Date of Electronic Publication: 2017 Jul 15 (Print Publication: 2017). - Publication Year :
- 2017
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Abstract
- The presence of circulating tumor cells (CTC) or microemboli (CTM) in the peripheral blood can theoretically anticipate malignancy of solid lesions in a variety of organs. We aimed to preliminarily assess this capability in patients with pulmonary lesions of suspected malignant nature. We used a cell-size filtration method (ScreenCell) and cytomorphometric criteria to detect CTC/CTM in a 3 mL sample of peripheral blood that was taken just before diagnostic percutaneous CT-guided fine needle aspiration (FNA) or core biopsy of the suspicious lung lesion. At least one CTC/CTM was found in 47 of 67 (70%) patients with final diagnoses of lung malignancy and in none of 8 patients with benign pulmonary nodules. In particular they were detected in 38 (69%) of 55 primary lung cancers and in 9 (75%) of 12 lung metastases from extra-pulmonary cancers. Sensitivity of CTC/CTM presence for malignancy was 70.1% (95%CI: 56.9-83.1%), specificity 100%, positive predictive value 100% and negative predictive value 28.6% (95%CI: 11.9-45.3%). Remarkably, the presence of CTC/CTM anticipated the diagnosis of primary lung cancer in 3 of 5 patients with non-diagnostic or inconclusive results of FNA or core biopsy, whereas CTC/CTM were not observed in 1 patient with sarcoidosis and 1 with amarthocondroma. These results suggest that presently, due to the low sensitivity, the search of CTC/CTM cannot replace CT guided percutaneous FNA or core biopsy in the diagnostic work-up of patients with suspicious malignant lung lesions. However, the high specificity may as yet indicate a role in cases with non-diagnostic or inconclusive FNA or core biopsy results that warrants to be further investigated.<br />Competing Interests: Competing Interests: The authors have declared that no competing interest exists.
Details
- Language :
- English
- ISSN :
- 1837-9664
- Volume :
- 8
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 28819424
- Full Text :
- https://doi.org/10.7150/jca.18418