Cytologic characteristics of circulating epithelioid cells in pancreatic disease

Matthew W. Rosenbaum, Christy E. Cauley, Birte Kulemann, Andrew S. Liss, Carlos Fernandez del Castillo, Andrew L. Warshaw, Keith D. Lillemoe, Sarah P Thayer, Martha B. Pitman

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND: Circulating epithelioid cells (CECs), also known as circulating tumor, circulating cancer, circulating epithelial, or circulating nonhematologic cells, are a prognostic factor in various malignancies that can be isolated via various protocols. In the current study, the authors analyzed the cytomorphologic characteristics of CECs isolated by size in a cohort of patients with benign and malignant pancreatic diseases to determine whether cytomorphological features could predict CEC origin. METHODS: Blood samples were collected from 9 healthy controls and 171 patients with pancreatic disease who were presenting for surgical evaluation before treatment. Blood was processed with the ScreenCell size-based filtration device. Evaluable CECs were analyzed in a blinded fashion for cytomorphologic characteristics, including cellularity; nucleoli; nuclear size, irregularity, variability, and hyperchromasia; and nuclear-to-cytoplasmic ratio. Statistical differences between variables were analyzed via the Fisher exact test. RESULTS: No CECs were identified among the 9 normal healthy controls. Of the 115 patients with CECs (positive or suspicious for), 25 had nonmalignant disease and 90 had malignancy. There were no significant differences in any of the cytologic criteria noted between groups divided by benign versus malignant, neoplastic versus nonneoplastic, or pancreatic ductal adenocarcinoma versus neuroendocrine tumor. CONCLUSIONS: CECs were observed in patients with malignant and nonmalignant pancreatic disease, but not in healthy controls. There were no morphologic differences observed between cells from different pancreatic diseases, suggesting that numerous conditions may be associated with CECs in the circulation and that care must be taken not to overinterpret cells identified by cytomorphology as indicative of circulating tumor cells of pancreatic cancer. Additional studies are required to determine the origin and clinical significance of these cells. Cancer Cytopathol 2017;125:332–340.

Original languageEnglish (US)
Pages (from-to)332-340
Number of pages9
JournalCancer Cytopathology
Volume125
Issue number5
DOIs
StatePublished - May 2017

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Epithelioid Cells
Pancreatic Diseases
Neoplasms
Circulating Neoplastic Cells
Neuroendocrine Tumors
Pancreatic Neoplasms
Cell Size
Adenocarcinoma
Equipment and Supplies

Keywords

  • circulating epithelial cells (CEC)
  • circulating tumor cells (CTC)
  • cytomorphological features
  • isolation by size of epithelial tumor cells (ISET)
  • pancreas

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Rosenbaum, M. W., Cauley, C. E., Kulemann, B., Liss, A. S., Castillo, C. F. D., Warshaw, A. L., ... Pitman, M. B. (2017). Cytologic characteristics of circulating epithelioid cells in pancreatic disease. Cancer Cytopathology, 125(5), 332-340. https://doi.org/10.1002/cncy.21841

Cytologic characteristics of circulating epithelioid cells in pancreatic disease. / Rosenbaum, Matthew W.; Cauley, Christy E.; Kulemann, Birte; Liss, Andrew S.; Castillo, Carlos Fernandez del; Warshaw, Andrew L.; Lillemoe, Keith D.; Thayer, Sarah P; Pitman, Martha B.

In: Cancer Cytopathology, Vol. 125, No. 5, 05.2017, p. 332-340.

Research output: Contribution to journalArticle

Rosenbaum, MW, Cauley, CE, Kulemann, B, Liss, AS, Castillo, CFD, Warshaw, AL, Lillemoe, KD, Thayer, SP & Pitman, MB 2017, 'Cytologic characteristics of circulating epithelioid cells in pancreatic disease', Cancer Cytopathology, vol. 125, no. 5, pp. 332-340. https://doi.org/10.1002/cncy.21841
Rosenbaum MW, Cauley CE, Kulemann B, Liss AS, Castillo CFD, Warshaw AL et al. Cytologic characteristics of circulating epithelioid cells in pancreatic disease. Cancer Cytopathology. 2017 May;125(5):332-340. https://doi.org/10.1002/cncy.21841
Rosenbaum, Matthew W. ; Cauley, Christy E. ; Kulemann, Birte ; Liss, Andrew S. ; Castillo, Carlos Fernandez del ; Warshaw, Andrew L. ; Lillemoe, Keith D. ; Thayer, Sarah P ; Pitman, Martha B. / Cytologic characteristics of circulating epithelioid cells in pancreatic disease. In: Cancer Cytopathology. 2017 ; Vol. 125, No. 5. pp. 332-340.
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