title: Detection of disseminated epithelial cancer cells by liquid culture--factors interfering with the standardization of assays.
abstract: BACKGROUND
  Immunocytochemistry is the standard method for detection of disseminated breast-cancer cells. Tumor-cell enrichment by cell culture has been used by several investigators, however assays published have not been well-standardized.
  
  
  METHODS
  Breast-cancer cells from two lines were diluted in hemopoietic cells of varying origins and cultured in different media and different flasks. Factors influencing successful tumor-cell amplification by liquid culture were identified by investigation of 277 cultures. Parallel clinical samples, consisting of BM aspirations, leukapheresis samples and peripheral blood samples obtained from women with breast cancer, were investigated in 113 cultures. Cancer-cell detection by cell culture could be compared to immunocytochemistry in 101 cases.
  
  
  RESULTS
  The frequency of tumor-cell detection was not improved by liquid culture, but a significant correlation between conventional tumor-cell detection and detection after liquid culture was found. Factors influencing tumor-cell amplification in the dilution assay could not be transferred to the investigation of clinical samples. It was concluded that culture-enrichment of disseminated cancer cells was very complex, and could be influenced by a variety of factors-even when a model system was used.
  
  
  CONCLUSIONS
  It should be recognized that culture-enriched cancer cells probably represent a highly selected population of disseminated cancer cells, despite the significant correlation between tumor cells detected by conventional methods and following conventional methods after liquid culture. There is currently no evidence to suggest that cancer-cell amplification by cell culture could become a standardized technique for the detection of disseminated epithelial tumor cells.
authors.affiliation: Bone Marrow Transplantation, Centre University-Hospital, Hamburg-Eppendorf, Germany.
authors.forename: W H
authors.initials: WH
authors.lastname: Krüger
authors.forename: A
authors.initials: A
authors.lastname: Lange
authors.forename: A
authors.initials: A
authors.lastname: Badbaran
authors.forename: K
authors.initials: K
authors.lastname: Gutensohn
authors.forename: N
authors.initials: N
authors.lastname: Kröger
authors.forename: A R
authors.initials: AR
authors.lastname: Zander
mesh_terms: D016477:Artifacts; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002452:Cell Count; D018929:Cell Culture Techniques / Q000379:methods* / Q000592:standards; D045744:Cell Line, Tumor; D003470:Culture Media; D005260:Female; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D007120:Immunochemistry; D009362:Neoplasm Metastasis; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000473:pathology; D014407:Tumor Cells, Cultured
chemical_list: D014408:Biomarkers, Tumor; D003470:Culture Media