Isolation of circulating epithelial and tumor progenitor cells with an invasive phenotype from breast cancer patients

Int J Cancer. 2010 Feb 1;126(3):669-83. doi: 10.1002/ijc.24814.


Recent research advances show that tumor cell intravasation (entry into the circulation) and metastasis occur very early in breast cancer progression. Clinical studies also illustrate the potential importance of detection of circulating tumor cells (CTCs) in outcomes of patients with metastatic breast cancer. Whether these cells exhibit the invasiveness and express tumor stem or progenitor markers, hallmark of the metastatic phenotype, is less well characterized. To detect CTCs with the invasive phenotype and to explore their molecular features, we applied a functional cell separation method, called collagen adhesion matrix (CAM) assay, as enrichment and identification steps. The CAM-coated device successfully recovered tumor cells spiked in 1 ml of blood with a 54% +/- 9% (n = 18) recovery rate and 0.5-35% purity, and detected invasive tumor cells in 10/10 blood samples (100% yield) from patients with metastatic breast cancer with a range of 18-256 CTCs/ml and average of 126 +/- 25 (mean +/- SD) CTCs/ml. CTCs were detected in blood samples of 28/54 (52%) Stage I-III breast cancer patients with a mean count of 61 CTCs/ml. Furthermore, the relative frequency of these cells correlated to the staging, lymph node-status and survival of patients with early stage breast cancer. CAM-captured cells were capable of propagation in culture. Gene expression and multiplex flow cytometric analyses on CAM-captured cells demonstrated the existence of distinct populations of CTCs including these of epithelial lineage and stem or progenitor cells. Thus, CAM-initiated CTC detection provides advantages for examining invasiveness and tumor progenitor phenotypes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Biomarkers, Tumor / analysis
  • Breast Neoplasms / blood
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Carcinoma, Ductal, Breast / blood
  • Carcinoma, Ductal, Breast / drug therapy
  • Carcinoma, Ductal, Breast / mortality
  • Carcinoma, Ductal, Breast / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / blood
  • Carcinoma, Intraductal, Noninfiltrating / drug therapy
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Cell Adhesion
  • Cell Line, Tumor / chemistry
  • Cell Line, Tumor / pathology
  • Cell Separation / methods*
  • Collagen
  • Disease Progression
  • Epithelial Cells / chemistry*
  • Epithelial Cells / drug effects
  • Female
  • Flow Cytometry / methods*
  • Humans
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Proteins / analysis
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / chemistry*
  • Neoplastic Cells, Circulating / classification
  • Neoplastic Cells, Circulating / drug effects
  • Neoplastic Stem Cells / chemistry*
  • Neoplastic Stem Cells / drug effects
  • Phenotype
  • Survival Analysis
  • Young Adult


  • Biomarkers, Tumor
  • Neoplasm Proteins
  • Collagen