title: Circulating Tumor Cells in Diagnosing Lung Cancer: Clinical and Morphologic Analysis.
abstract: BACKGROUND
  The purpose of this study was to evaluate the value of circulating non-hematologic cells to differentiate benign from malignant lung lesions and their comparison with clinico-histologic features of corresponding primary lesions.
  
  
  METHODS
  Circulating cells were isolated by size method from peripheral blood of 77 patients with malignant (n = 60) and benign (n = 17) lung lesions. They were morphologically classified as cells with malignant feature; cells with uncertain malignant feature; and cells with benign feature; then statistically correlated with clinico-cytopathologic characteristics of corresponding lung lesion.
  
  
  RESULTS
  Malignant circulating cells were detected in 54 of 60 (90%) malignant patients, and in 1 of 17 (5%) benign patients; benign circulating cells in 1 of 60 (1%) malignant patients and in 15 of 17 (88%) benign patients; and circulating cells with uncertain malignant aspect in 5 of 60 (8%) malignant patients and 1 of 17 (5%) benign patients. For a malignant circulating cells count greater than 25, sensitivity and specificity were 89% and 100%, respectively. The count was significantly correlated with stage, size, and standard uptake value of primary tumor. In 39 of 54 (72%) cases, the malignant circulating cells allowed a specific histologic diagnosis of the corresponding primary tumor after immunohistochemical analysis.
  
  
  CONCLUSIONS
  Malignant circulating cells may be a valid marker in the diagnostic workup of lung lesions. However, our resuts should be corroborated by larger future studies especially for patients having small nodules.
authors: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors: Alfonso
authors: A
authors: Fiorelli
authors: Department of Morphopathology, Second University of Naples, Naples, Italy.
authors: Marina
authors: M
authors: Accardo
authors: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors: Emanuele
authors: E
authors: Carelli
authors: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors: Denise
authors: D
authors: Angioletti
authors: Thoracic Surgery Unit, Second University of Naples, Naples, Italy. Electronic address: mario.santini@unina2.it.
authors: Mario
authors: M
authors: Santini
authors: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy; Sbarro Institute for Cancer Research and Molecular Medicine and Center for Biotechnology, Temple University, Philadelphia, Pennsylvania.
authors: Marina
authors: M
authors: Di Domenico
mesh_terms: D000368:Aged; D002452:Cell Count; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results