• Finding Circulating Tumor Cells in Patients With Pancreaticobiliary Cancers

Finding Circulating Tumor Cells in Patients With Pancreaticobiliary Cancers

Circulating tumor cells (CTCs) can be isolated from portal venous blood collected during endoscopic ultrasound (EUS) of patients with pancreaticobiliary cancers, researchers report in the December issue of Gastroenterology.

CTCs isolated from peripheral blood of patients with metastatic breast, colorectal, or prostate cancer can be analyzed to predict patient survival. However, blood samples from patients with pancreatic and biliary cancers contain very low numbers of CTCs.

Daniel V.T. Catenacci et al investigated whether these tumor cells might be found in portal vein blood, and collected via EUS.

Under EUS guidance, the authors inserted a 19-gauge fine needle transhepatically into portal veins of 18 patients; 7.5-mL aliquots of blood were aspirated. CTCs were isolated based on expression of cytokeratins 8, 18, and/or 19 and lack of CD45 expression.

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The authors found CTCs in all the portal vein blood samples, but in less than 25% of peripheral blood samples.

The cells were analyzed for expression of tumor marker such as P16, SMAD4, and P53. DNA was extracted from the tumor cells for sequencing of select KRAS codons.

“Isolation of CTCs from the portal venous blood provides a sufficient number of cells to perform proteomic and genetic analysis”, senior author Irving Waxman says in a video abstract of the article.

The authors state that the portal vein CTCs can be used to study the pathogenesis and progression of pancreaticobiliary cancers, and might be used to assess cancer progresssion and to predict response to therapy.

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