Inertia based microfluidic capture and characterisation of circulating tumour cells for the diagnosis of lung cancer.
BACKGROUND
Routine clinical application of circulating tumour cells (CTCs) for blood based diagnostics is yet to be established. Despite growing evidence of their clinical utility for diagnosis, prognosis and treatment monitoring, the efficacy of a robust platform and universally accepted diagnostic criteria remain uncertain. We evaluate the diagnostic performance of a microfluidic CTC isolation platform using cytomorphologic criteria in patients undergoing lung cancer surgery.


METHODS
Blood was processed from 51 patients undergoing surgery for known or suspected lung cancer using the ClearBridge ClearCell FX systemTM(ClearBridge Biomedics, Singapore). Captured cells were stained on slides with haematoxylin and eosin (H&E) and independently assessed by two pathologist teams. Diagnostic performance was evaluated against the pathologists reported diagnosis of cancer from surgically obtained specimens.


RESULTS
Cancer was diagnosed in 43.1% and 54.9% of all cases. In early stage primary lung cancer, between the two reporting teams, a positive diagnosis of CTCs was made for 50% and 66.7% of patients. The agreement between the reporting teams was 80.4%, corresponding to a kappa-statistic of 0.61±0.11 (P<0.001), indicating substantial agreement. Sensitivity levels for the two teams were calculated as 59% (95% CI, 41-76%) and 41% (95% CI, 24-59%), with a specificity of 53% for both.


CONCLUSIONS
The performance of the tested microfluidic antibody independent device to capture CTCs using standard cytomorphological criteria provides the potential of a diagnostic blood test for lung cancer.
National Heart and Lung Institute, Imperial College London, London, UK;; Division of Thoracic Surgery, Harefield Hospital, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK;; Division of Biosciences, Brunel University London, London, UK.
Dimple Y
DY
Chudasama
National Heart and Lung Institute, Imperial College London, London, UK;; Academic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Daria V
DV
Freydina
National Heart and Lung Institute, Imperial College London, London, UK;; Academic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Maxim B
MB
Freidin
National Heart and Lung Institute, Imperial College London, London, UK;; Academic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Maria
M
Leung
National Heart and Lung Institute, Imperial College London, London, UK;; Department of Histopathology, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Angeles
A
Montero Fernandez
National Heart and Lung Institute, Imperial College London, London, UK;; Department of Histopathology, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Alexandra
A
Rice
National Heart and Lung Institute, Imperial College London, London, UK;; Department of Histopathology, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Andrew G
AG
Nicholson
Division of Biosciences, Brunel University London, London, UK.
Emmanouil
E
Karteris
Division of Thoracic Surgery, Harefield Hospital, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Vladimir
V
Anikin
National Heart and Lung Institute, Imperial College London, London, UK;; Academic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, UK.
Eric
E
Lim
Circulating tumour cells (CTCs); ClearBridge; lung cancer