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A total of 49 blood samples from metastatic breast cancer patients were tested with two CTC assay methods and the numbers of CTC detected from individual patients are shown in Table 3 (only shows the CTC-positive individuals either by CellSearch™ or our CTC method).
By contrast, lymph node metastases from patient No. 9 showed a BRAFV600E mutation while two CTC showed wild-type BRAF.
Here, we compared the performance of two CTC detection systems based on the expression of the EpCAM antigen (CellSearch assay) or on cell size (ISET assay).
The slope of a linear regression curve was calculated for each patient, including at least three time points and two CTC counts per time point.
The AdnaTest Breast Cancer Select/Detect technique was performed independently of the other two CTC assays by the Laboratory for Molecular Biology (IB) (Labo Lokeren, Campus RIATOL, Antwerp, Belgium), which was blinded to the other assay results.
No statistically significant difference was found between the two CTC groups in terms of treatment strategy (systemic treatment alone or systemic treatment plus additional locoregional treatment) and type of systemic treatment (chemotherapy, endocrine therapy or other).
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The test is reported to be sensitive enough to detect two CTCs in a 5 mL sample of blood [57].
Overlayed iFISH image indicated that instead of two CTCs respectively identified by immunostaining or FISH alone, all of 3 non-hematopoietic cells were CTCs.
We found that both CellSearch® and the two CTC-chip platforms tested here were effective at capturing high-EpCAM expressing cells, but efficiency fell to below 50% for cells expressing lower EpCAM levels.
Also, eight patients had HER2 3+ tumours and four of these had HER2 amplification in cfDNA, but these did not overlap with the two CTC-positive patients.
For these reasons our distinction of two CTCs subpopulation (CTC-EP, CTC-EMT) may represent some study limitations.
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