545 research outputs found

    Circulating tumor cells detection and counting in uveal melanomas by a filtration-based method

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    Uveal melanoma is one of the most deadly diseases in ophthalmology for which markers able to predict the appearance of metastasis are needed. The study investigates the role of circulating tumor cells (CTC) as a prognostic factor in this disease. We report the detection of circulating tumor cells by Isolation by Size of Epithelial Tumor cells (ISET) in a cohort of 31 uveal melanoma patients: we identified single CTCs or clusters of cells in 17 patients, while the control population, subjects with choroidal nevi, showed no CTC in peripheral blood. The presence of CTCs did not correlate with any clinical and pathological parameter, such as tumor larger basal diameter (LBD), tumor height and TNM. By stratifying patients in groups on the basis of the number of CTC (lower or higher than 10 CTC per 10 mL blood) and the presence of CTC clusters we found a significant difference in LBD (p = 0.019), Tumor height (p = 0.048), disease-free and overall survival (p < 0.05). In conclusion, we confirm the role of CTC as a negative prognostic marker in uveal melanoma patients after a long follow-up period. Further characterization of CTC will help understanding uveal melanoma metastasization and improve patient management. © 2014 by the authors; licensee MDPI, Basel, Switzerland

    Novel approaches in cancer management with circulating tumor cell clusters

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    © 2019 The Authors Tumor metastasis is responsible for the vast majority of cancer-associated morbidities and mortalities. Recent studies have disclosed the higher metastatic potential of circulating tumor cell (CTC) clusters than single CTCs. Despite long-term study on metastasis, the characterizations of its most potent cellular drivers, i.e., CTC clusters have only recently been investigated. The analysis of CTC clusters offers new intuitions into the mechanism of tumor metastasis and can lead to the development of cancer diagnosis and prognosis, drug screening, detection of gene mutations, and anti-metastatic therapeutics. In recent years, considerable attention has been dedicated to the development of efficient methods to separate CTC clusters from the patients’ blood, mainly through micro technologies based on biological and physical principles. In this review, we summarize recent developments in CTC clusters with a particular emphasis on passive separation methods that specifically have been developed for CTC clusters or have the potential for CTC cluster separation. Methods such as liquid biopsy are of paramount importance for commercialized healthcare settings. Furthermore, the role of CTC clusters in metastasis, their physical and biological characteristics, clinical applications and current challenges of this biomarker are thoroughly discussed. The current review can shed light on the development of more efficient CTC cluster separation method that will enhance the pivotal understanding of the metastatic process and may be practical in contriving new strategies to control and suppress cancer and metastasis

    Prognostic and monitoring value of circulating tumour cells in adrenocortical carcinoma: a preliminary monocentric study.

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    Adrenocortical carcinoma (ACC), a rare and aggressive neoplasia, presents poor prognosis when metastatic at diagnosis and limited therapies are available. Specific and sensitive markers for early diagnosis and a monitoring system of therapy and tumor evolution are urgently needed. The liquid biopsy represents a source of tumor material within a minimally invasive blood draw that allows the recovery of circulating tumor cells (CTCs). CTCs have been recently shown to be detectable in ACC. In the present paper, we evaluated the prognostic value of CTCs obtained by size-filtration in a small pilot cohort of 19 ACC patients. We found CTCs in 68% of pre-surgery and in 38% of post-surgery blood samples. In addition, CTC clusters (CTMs) and cancer associated macrophages (CAMLs) were detectable in some ACC patients. The median number of CTCs significantly decreased after the mass removal. Finally, stratifying patients in high and low pre-surgery CTC number groups, assuming the 75th percentile CTC value as cut-off, CTCs significantly predicted patients’ overall survival (log rank = 0.005), also in a multivariate analysis adjusted for age and tumor stage. In conclusion, though preliminary and performed in a small cohort of patients, our study suggests that CTC number may represent a promising marker for prognosis and disease monitoring in ACC

    Aspects of leucocyte and fat filtration during cardiac surgery

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    Na een hartoperatie treden vaak door het hele lichaam ontstekingsreacties op. Door het bloed tijdens de operatie te filteren, lopen patiënten minder risico op beschadigingen in longen, hart en hersenen, ontdekte Hans de Vries. Tijdens een hartoperatie neemt de hart-longmachine een aantal lichaamsfuncties over. Deze machine vormt door zijn grote contactoppervlak met het bloed van de patiënt een enorme prikkel voor stollings- en ontstekingsreacties. De ontstekingen kunnen het hele lichaam treffen en zorgen daar voor weefselbeschadigingen. Een sleutelrol in dit schadelijke proces spelen witte bloedlichaampjes (leukocyten) en vetdeeltjes die tijdens de operatie in de bloedbaan komen. De Vries experimenteerde met twee filters die respectievelijk leukocyten en vetdeeltjes uit het bloed verwijderen. Hij ontdekte dat er minder ontstekingsreacties en weefselbeschadigingen optreden wanneer de leukocyten worden gefilterd uit het restbloed van de hart-longmachine. De patiënten blijken dan na de operatie een betere longfunctie te hebben. Het filter vangt overigens niet alle leukocyten weg; het verwijdert vooral de geactiveerde, ziekmakende witte bloedlichaampjes. Ook een vetdeeltjesfilter zorgt voor minder ontstekingsreacties. Voor de patiënten had dit echter geen merkbare gevolgen. Vermoedelijk laat de effectiviteit van dit filter nog te wensen over.

    Acute pulmonary hypertension caused by tumor embolism: a report of two cases.

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    Acute pulmonary hypertension leading to right ventricular failure and circulatory collapse is usually caused by thromboembolic obstruction of the pulmonary circulation. However, in rare instances, other causes can be associated with a similar clinical presentation. We present and discuss the clinical histories of two patients with acute right ventricular failure due to an atypical cause of pulmonary hypertension, disseminated pulmonary tumor embolism

    Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

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    This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs

    Microfluidic Liquid Biopsy for Cancer Prognosis

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    Leukemia is a deadly and common cancer, especially in children and adolescents. The misdiagnosis and unexpected complications during the treatment are some factors that increase the mortality rate of leukemia. The goal of our project was to create a device that would quickly and accurately assess these complications. While there are existing tests that can perform a single test for either metastasis or sepsis, there are none that can test for both simultaneously and rapidly. We propose to modify and combine some of these existing microfluidic designs as well as create a new component to perform a combinatorial assessment. While we were unable to verify the results, we have designed a device that will potentially meet our goals of testing for sepsis, severe sepsis, solid-body metastasis risk, major solid-body metastasis risk, lymphoma metastasis risk, and progression of the primary blood-based cancer (leukemia/lymphoma), from 7.5 mL of blood in just under 2 hours. We believe that this device has the potential to contribute to the medical field due to its speed and efficiency, especially in a pediatric demographic

    Cooperative and Escaping Mechanisms between Circulating Tumor Cells and Blood Constituents

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    Metastasis is the leading cause of cancer-related deaths and despite measurable progress in the field, underlying mechanisms are still not fully understood. Circulating tumor cells (CTCs) disseminate within the bloodstream, where most of them die due to the attack of the immune system. On the other hand, recent evidence shows active interactions between CTCs and platelets, myeloid cells, macrophages, neutrophils, and other hematopoietic cells that secrete immunosuppressive cytokines, which aid CTCs to evade the immune system and enable metastasis. Platelets, for instance, regulate inflammation, recruit neutrophils, and cause fibrin clots, which may protect CTCs from the attack of Natural Killer cells or macrophages and facilitate extravasation. Recently, a correlation between the commensal microbiota and the inflammatory/immune tone of the organism has been stablished. Thus, the microbiota may affect the development of cancer-promoting conditions. Furthermore, CTCs may suffer phenotypic changes, as those caused by the epithelial–mesenchymal transition, that also contribute to the immune escape and resistance to immunotherapy. In this review,we discuss the findings regarding the collaborative biological events among CTCs, immune cells, and microbiome associated to immune escape and metastatic progression
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