TY - JOUR
T1 - Tumor cells are dislodged into the pulmonary vein during lobectomy
AU - Yao, Xiaosai
AU - Williamson, Christina
AU - Adalsteinsson, Viktor A.
AU - D'Agostino, Richard S.
AU - Fitton, Torin
AU - Smaroff, Gregory G.
AU - William, Robert T.
AU - Wittrup, K. Dane
AU - Love, J. Christopher
N1 - Funding Information:
This work was supported in part by the Koch Institute Support (core) Grant P30-CA14051 from the National Cancer Institute . X. Yao was supported by the National Science Scholarship from A*STAR, Singapore . V. A. Adalsteinsson was supported in part by a graduate fellowship from the National Science Foundation . J. C. Love is a Camille Dreyfus Teacher-Scholar. This work was supported by Janssen Pharmaceuticals, Inc .
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Objective Intraoperative tumor shedding may facilitate tumor dissemination. In earlier studies, shed tumor cells were defined primarily by cytomorphological examination, and normal epithelial cells could not always be distinguished from tumor cells. We sought to accurately identify tumor cells using single-cell sequencing and determine whether these cells were mobilized into the circulation during pulmonary lobectomy.Results The mean number of EpCAM+ cells in video-assisted thoracoscopy (VATS) lobectomy (no wedge) specimens (n = 16) was 165 (median, 115; range, 0-509) but sampling cells from 3 patients indicated that only 0% to 38% of the EpCAM+ cells were tumor cells. The mean number of EpCAM+ cells in VATS lobectomy (wedge) specimens (n = 12) was 1128 (median, 197; range, 47-9406) and all of the EpCAM+ cells were normal epithelial cells in 2 patients sampled. The mean number of EpCAM+ cells in thoracotomy specimens (n = 14) was 238 (median, 22; range, 9-2920) and 0% to 50% of total EpCAM+ cells were tumor cells based on 4 patients sampled.Conclusions Surgery mobilizes tumor cells into the pulmonary vein, along with many normal epithelial cells. EpCAM alone cannot differentiate between normal and tumor cells. On the other hand, single-cell genetic approaches with patient-matched normal and tumor tissues can accurately quantify the number of shed tumor cells.
AB - Objective Intraoperative tumor shedding may facilitate tumor dissemination. In earlier studies, shed tumor cells were defined primarily by cytomorphological examination, and normal epithelial cells could not always be distinguished from tumor cells. We sought to accurately identify tumor cells using single-cell sequencing and determine whether these cells were mobilized into the circulation during pulmonary lobectomy.Results The mean number of EpCAM+ cells in video-assisted thoracoscopy (VATS) lobectomy (no wedge) specimens (n = 16) was 165 (median, 115; range, 0-509) but sampling cells from 3 patients indicated that only 0% to 38% of the EpCAM+ cells were tumor cells. The mean number of EpCAM+ cells in VATS lobectomy (wedge) specimens (n = 12) was 1128 (median, 197; range, 47-9406) and all of the EpCAM+ cells were normal epithelial cells in 2 patients sampled. The mean number of EpCAM+ cells in thoracotomy specimens (n = 14) was 238 (median, 22; range, 9-2920) and 0% to 50% of total EpCAM+ cells were tumor cells based on 4 patients sampled.Conclusions Surgery mobilizes tumor cells into the pulmonary vein, along with many normal epithelial cells. EpCAM alone cannot differentiate between normal and tumor cells. On the other hand, single-cell genetic approaches with patient-matched normal and tumor tissues can accurately quantify the number of shed tumor cells.
UR - https://www.scopus.com/pages/publications/84920040394
U2 - 10.1016/j.jtcvs.2014.06.074
DO - 10.1016/j.jtcvs.2014.06.074
M3 - Article
C2 - 25172322
AN - SCOPUS:84920040394
SN - 0022-5223
VL - 148
SP - 3224-3231.e5
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -