Determination of circulating tumor cells by flow cytometry in the lung cancer patients

Circulating tumor cells (CTCs) play a crucial role in the metastatic spread of carcinoma. Therefore, CTC has been interest of a subject in the past few decades in terms of prognosis and response to the therapy in several cancer diseases. Recent improvements in technical approaches maintain to identify CTCs from whole blood have demonstrated the potential value of CTC detection as a liquid biopsy especially in those tumors where tissue accessibility is often challenging as in lung cancer. Lung cancer is the most common cause of death from cancer worldwide in both men and women which is commonly metastasize before it is diagnosed. The aim of this study is to determine of CTCs in peripheral blood sample (7.5 mL) of lung cancer patients by the modified method. This method enrolled on 9 patients with lung cancer and 9 healthy volunteers which consists of a ficoll density gradient centrifugation and a magnetic microbead separation technique by CD45 negative selection method enrichment step. Finally, we determined CTCs through the expression of anti-epithelial cell adhesion molecule (EpCAM) and cytokeratins (CK7,8,14,15,16,19) by multi-parameter flow cytometry. Consequently, we can indicate that, CTCs were detected in all of patients but no CTCs were evaluated on healthy volunteers (Z=3.823; p<0.001). Thus, CTCs were detectable in peripheral blood sample of lung cancer patients using with our method.