Tumor cells are dislodged into the pulmonary vein during lobectomy
Author(s)
Yao, Xiaosai; Williamson, Christina; D'Agostino, Richard S.; Fitton, Torin; Smaroff, Gregory G.; Wittrup, Karl Dane; Williams, Robert T.; Love, John C; Adalsteinsson, Viktor A.; ... Show more Show less
DownloadLove_Tumor cells.pdf (871.4Kb)
PUBLISHER_CC
Publisher with Creative Commons License
Creative Commons Attribution
Terms of use
Metadata
Show full item recordAbstract
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.
Methods
Forty-two blood samples collected from the tumor-draining pulmonary vein at the end of lobectomy procedures were analyzed. Arrays of nanowells were used to enumerate and retrieve single EpCAM[superscript +] cells. Targeted sequencing of 10 to 15 cells and nested polymerase chain reaction of single cells detected somatic mutations in shed epithelial cells consistent with patient-matched tumor but not normal tissue.
Results
The mean number of EpCAM[superscript +] 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[superscript +] cells were tumor cells. The mean number of EpCAM[superscript +] cells in VATS lobectomy (wedge) specimens (n = 12) was 1128 (median, 197; range, 47-9406) and all of the EpCAM[superscript +] cells were normal epithelial cells in 2 patients sampled. The mean number of EpCAM[superscript +] cells in thoracotomy specimens (n = 14) was 238 (median, 22; range, 9-2920) and 0% to 50% of total EpCAM[superscript +] 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.
Date issued
2014-07Department
Massachusetts Institute of Technology. Department of Biological Engineering; Massachusetts Institute of Technology. Department of Chemical Engineering; Koch Institute for Integrative Cancer Research at MITJournal
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier
Citation
Yao, Xiaosai, Christina Williamson, Viktor A. Adalsteinsson, Richard S. D’Agostino, Torin Fitton, Gregory G. Smaroff, Robert T. William, K. Dane Wittrup, and J. Christopher Love. “Tumor Cells Are Dislodged into the Pulmonary Vein During Lobectomy.” The Journal of Thoracic and Cardiovascular Surgery 148, no. 6 (December 2014): 3224–3231.e5.
Version: Author's final manuscript
ISSN
00225223