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Clinicians can withdraw enough blood to guarantee a sufficient sample of CTCs, just a few milliliters out of five or so liters on average, with minimal impact to the patient.
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The ability of the MCC for patient sample processing of CTCs for enumeration was demonstrated with five patient samples, revealing an average of 0.31 CTCs /mL.
Over this period of sampling for CTCs, we obtained 68 bone marrow samples for DTC analysis; 13 patients in group II and one patient in group III were tested once, and 27 patients in group III at two time points.
In an experiment with a blood sample containing 200mL of CTCs and 5 billion blood cells, the device captured a whopping 170mL of CTCs and only 91mL of irrelevant blood cells.
Finally, a possible explanation for the lower inter-reader agreement in samples drawn after the administration of systemic treatment is the presence in these samples of granular CTCs that have been demonstrated to be mainly apoptotic, and to be a source of inter-reader disagreement in a previous study [ 23].
A total of seven CTCs were isolated in the samples of all CTC-positive subjects with a mean size of 8 × 6 μm (range of the longest diameter, 5 12 μm) (Fig. 4).
Because the total blood volume (5 L) is much greater than the aliquot volume (7.5 mL) and the CTCs are considered to be relatively rare count data, the observed CTC count from a 7.5 mL aliquot of blood was interpreted as a random sample of the total CTC count.
9 For instance, Tibbe et al. 9 identified three major sources of variation in CTC counting: (1) the Poisson-distributed sampling error of the number of CTCs in a blood sample; (2) the variability in enrichment efficiency; and (3) the intrareader and interreader variabilities.
Additionally, repeated sampling and molecular analysis of CTCs could help to uncover traits of cancer cells selected under therapy early on and could enable physicians to rapidly adapt treatment strategies.
In this study we have developed magnetic force gradient based microfluidic chip (Mag-Gradient Chisolatingsolatheg totalotal number of CTCs in the sample and characterizing the state of CTCs simultaneously with respect to the epithelial cell adhesion molecule (EpCAM) expression level.
Blood sample collection and MagSweeper isolation of CTCs were isolated as previously described [ 19, 21].
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