Detection of disseminated tumor cells in aspirative drains after neck dissection

Abstract

The dissemination of individual tumor cells is a common phenomenon in solid cancers. Detection of tumor cells in bone marrow disseminated tumor cells (DTC) and in peripheral blood circulating tumor cells (CTC) in nonmetastatic situation is of high prognostic significance. Compared to breast, colon and prostate cancers, the studies on CTC and DTC in head and neck cancers are sparse. The objective of our study was to detect DTC in drains after neck dissection. Fourteen patients undergoing surgery for stages III and IV head and neck cancers were enrolled in this study--twelve presenting with squamous cell carcinoma and two with adenocarcinoma. Redon drain analysis was performed by the Cellsearch method using immunomagnetic and fluorescence approaches. A positivity threshold value was set at 2DTC/7.5 ml of the sample. Tumor cells were detected in drains of 69 % of patients a few days after surgery. The range of quantification was 3-2,094 DTC/5 ml and we showed morphological differences between the two types of carcinoma cells. DTC were detected after neck dissection both in squamous cell carcinoma and in adenocarcinoma. Potential clinical significance of tumor cells needs to be further investigated as their presence could affect pre-surgical and post-operative treatments.

Circulating tumor cells in head and neck cancer: A review

“…They detected between 3 and 2094 CTCs/ml in 64% patients using the CellSearch method, although the clinical significance is still unknown. 28 One of the limitations of the immunocytochemical tests is the variability in CTC recovery rates. As noted before, the rarity of these cells in peripheral blood is one of the main challenges to overcome.…”

Detection of circulating tumor cells after surgery for stage III and IV squamous cell carcinoma of the head and neck

“…As follows from our results (Table 2), despite the absence of specific Kit for H&N cancers, the CellSearch System seems practicable using Epithelial Kit and EGFR. In our recent study we already demonstrated the possibility to detect DTC with Cell Search in drains after neck dissection in 14 patients undergoing surgery for stages III and IV H&N cancers [9]. Tumor cells were detected in the drains of 69% of patients a few days after surgery.…”

“…In our study, we used iScript Advanced cDNA Synthesis Kit [9]. This kit is an enhanced formulation composed of nuclease-free water, reverse transcriptase enzyme and a reaction mix with dNTPs and oligo(dt).…”

“…In the absence of detection kit for head and neck cancer, we used CellSearch epithelial Kit and EGFR. CellSearch Circulating Tumor Cell Kit is intended for the enumeration of circulating tumor cells of epithelial origin in whole blood [7][8][9].…”

Improving the CellSearch® system

“…[127][128][129]. The same method is used to find tumor cells in the fluid of the drain used by a head and neck cancer dissection [130]. Also for leukapheresis samples, which are concentrated mononuclear cells from blood, the same method is used.…”