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Cytology and cell‐block immunohistochemistry of circulating tumour cells
Author(s) -
Mayall Frederick George,
Pepperell Justin,
Bodger Ian,
Higbee Daniel,
Stevanato Lara,
Hustler Arianna,
Mumford Kyra Mhairi
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12770
Subject(s) - cytokeratin , medicine , metastatic carcinoma , immunohistochemistry , pathology , carcinoma , cytology , circulating tumor cell , biopsy , cancer , metastasis
Objective The study set out to assess the feasibility of using Parsortix TM circulating tumour cell ( CTC ) extraction and CytoFoam Disc cell‐block immunohistochemistry to diagnose metastatic carcinoma from blood samples in a National Health Service district general hospital. Methods Blood samples were taken from 50 patients with metastatic carcinoma and 50 healthy volunteers and processed, using a previously published method, to extract CTC s and collect them in a cell‐block for routine formalin‐fixed paraffin sectioning and immunohistochemistry. The extracted cells were compared with the patients’ routine diagnostic samples. Results The samples from the 50 carcinoma patients showed cytokeratin‐positive cells in 19 cases. In eight of these, the cytokeratin‐positive cells had a similar immunoprofile to the carcinoma in the conventional biopsy or cytology specimen. Some carcinoma patients also had circulating cytokeratin‐positive cells that were probably benign epithelial cells and circulating megakaryocytes. Both of these types of cells were also found in healthy volunteers. Processing and initial examination could be completed in 2 days. The full processing cost was approximately £316 per case. Conclusions CTCs could be extracted from the blood of some patients with metastatic carcinoma and formed into a formalin‐fixed cell‐block for routine paraffin processing and immunohistochemistry. The specificity of this approach is constrained by the observation that some patients with metastatic carcinoma had circulating cytokeratin‐positive cells that were probably benign, and these were also found in healthy volunteers. Circulating megakaryocytes were present in carcinoma patients and healthy volunteers.