Sulaiman Raed, De Pradip, Aske Jennifer C, Lin Xiaoqian, Dale Adam, Vaselaar Ethan, Ageton Cheryl, Gaster Kris, Espaillat Luis Rojas, Starks David, Dey Nandini
Department of Pathology, Avera Cancer Institute, Sioux Falls, SD 57105, USA.
Translational Oncology Laboratory, Avera Research Institute, Sioux Falls, SD 57105, USA.
Cancers (Basel). 2022 Sep 21;14(19):4577. doi: 10.3390/cancers14194577.
The blood of patients with solid tumors contains circulating tumor-associated cells, including epithelial cells originating from the tumor mass, such as circulating tumor cells (CTCs), or phagocytic myeloid cells (differentiated monocytes), such as circulating cancer-associated macrophage-like cells (CAMLs). We report for the first time the identification and in-depth morphologic characterization of CAMLs in patients with endometrial cancers. We isolated CAMLs by size-based filtration on lithographically fabricated membranes followed by immunofluorescence, using a CD45+/CK 8,18,19+/EpCAM+/CD31+/macrophage-like nuclear morphology, from > 70 patients. Irrespective of the histological and pathological parameters, 98% of patients were positive for CAMLs. Two size-based subtypes of CAMLs, <20 µm (tiny) and >20 µm (giant) CAMLs, of distinctive polymorphic morphologies with mononuclear or fused polynuclear structures in several morphological states were observed, including apoptotic CAMLs, CAML−WBC doublets, conjoined CAMLs, CAML−WBC clusters, and CTC−CAML−WBC clusters. In contrast, CAMLs were absent in patients with non-neoplastic/benign tumors, healthy donors, and leucopaks. Enumerating CTCs simultaneously from the same patient, we observed that CTC-positive patients are positive for CAMLs, while 55% out of all CAML-positive patients were found positive for CTCs. Our study demonstrated for the first time the distinctive morphological characteristics of endometrial CAMLs in the context of the presence of CTCs in patients.
实体瘤患者的血液中含有循环肿瘤相关细胞,包括源自肿瘤块的上皮细胞,如循环肿瘤细胞(CTC),或吞噬性髓样细胞(分化的单核细胞),如循环癌相关巨噬细胞样细胞(CAML)。我们首次报告了子宫内膜癌患者中CAML的鉴定和深入形态学特征。我们通过光刻制造的膜上基于大小的过滤,然后进行免疫荧光,使用CD45+/CK 8,18,19+/EpCAM+/CD31+/巨噬细胞样核形态,从70多名患者中分离出CAML。无论组织学和病理学参数如何,98%的患者CAML呈阳性。观察到两种基于大小的CAML亚型,<20 µm(微小)和>20 µm(巨大)CAML,具有独特的多态形态,在几种形态状态下具有单核或融合多核结构,包括凋亡CAML、CAML-WBC双峰、连体CAML、CAML-WBC簇和CTC-CAML-WBC簇。相比之下,非肿瘤/良性肿瘤患者、健康供体和白细胞袋中不存在CAML。从同一患者同时计数CTC,我们观察到CTC阳性患者CAML呈阳性,而所有CAML阳性患者中有55%被发现CTC呈阳性。我们的研究首次证明了在患者存在CTC的情况下子宫内膜CAML的独特形态特征。