title: Prevalence and number of circulating tumour cells and microemboli at diagnosis of advanced NSCLC.
abstract: OBJECTIVE
  Timing and magnitude of blood release of circulating tumour cells (CTC) and circulating tumour microemboli (CTM) from primary solid cancers are uncertain. We investigated prevalence and number of CTC and CTM at diagnosis of advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Twenty-eight consecutive patients with suspected stage III-IV lung cancer gave consent to provide 15 mL of peripheral blood soon before diagnostic CT-guided fine-needle aspiration biopsy (FNAB). CTC and CTM (clusters of ≥3 CTC) were isolated by cell size filtration (ScreenCell), identified and counted by cytopathologists using morphometric criteria and (in 6 cases) immunostained for vimentin.
  
  
  RESULTS
  FNAB demonstrated NSCLC in 26 cases. At least one CTC/3 mL blood (mean 6.8 ± 3.7) was detected in 17 (65 %) and one CTM (mean 4.5 ± 3.3) in 15 (58 %) of 26 NSCLC cases. No correlation between number of CTC or CTM and tumour type or stage was observed. Neoplastic cells from both FNA and CTC/CTM were positive for vimentin but heterogeneously.
  
  
  CONCLUSIONS
  CTC can be detected in two-thirds and CTM in more than half of patients with advanced NSCLC at diagnosis. Reasons underlying lack of CTC and CTM in some advanced lung cancers deserve further investigations.
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy. m.mascalchi@dfc.unifi.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Mascalchi
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Falchini
authors.affiliation: Oncological Prevention Laboratory, Cancer Prevention and Research Institute (ISPO), Florence, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Maddau
authors.affiliation: Clinical Biochemistry Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Salvianti
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Nistri
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bertelli
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy.
authors.forename: Lapo
authors.initials: L
authors.lastname: Sali
authors.affiliation: Diagnostic and Interventional Radiology Units, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Zuccherelli
authors.affiliation: Nuclear Medicine Unit, Le Scotte University Hospital, Siena, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vella
authors.affiliation: Oncological Prevention Laboratory, Cancer Prevention and Research Institute (ISPO), Florence, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Matucci
authors.affiliation: Division of Thoracic Surgery, Careggi Hospital, Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Voltolini
authors.affiliation: Division of Pneumonology, Careggi Hospital, Florence, Italy.
authors.forename: Andrea Lopes
authors.initials: AL
authors.lastname: Pegna
authors.affiliation: Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Michaela
authors.initials: M
authors.lastname: Luconi
authors.affiliation: Clinical Biochemistry Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Pinzani
authors.affiliation: Clinical Biochemistry Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Pazzagli
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D044963:Biopsy, Fine-Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D014746:Vimentin / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D014746:Vimentin
keywords: Circulating tumour cells; Circulating tumour microemboli; Non-small cell lung cancer