Figure 1.

Circulating tumor microemboli (CTM) and circulating tumor cells (CTCs) in lung cancer patients. A: The archival diagnostic cytology specimen from our index patient with non-small cell lung cancer (NSCLC), procured 1 month before recruitment to the study. Cells were obtained by fine needle aspirate from an axillary lymph node metastasis and spread onto a glass slide. Morphological analysis with Papanicolaou's staining confirmed the diagnosis of NSCLC. B: The representative image of CTM isolated by ISET from the same patient as described in A. C: An image of CTM isolated by ISET from patient 1 with extensive stage small cell lung cancer (SCLC). The black circles are the 8 μm pores in the ISET membranes. Membranes were stained for the leukocyte marker CD45 and contaminant white blood cells (WBCs) were identified by positive brown CD45 staining (shown with arrow). D: Typical images (composite and single pseudo-color fluorescence) for CD45 negative, cytokeratin positive, and DAPI stained SCLC CTM identified by CellSearch technology (see Materials and Methods), with the intact and homogenous DAPI stained nuclei of viable CTCs compared to the nuclei of apoptotic CTCs in Figure 1E. E: Similar CellSearch gallery presentations of apoptotic single CTCs with condensed or fragmented DAPI stained nuclei. F: Tabulation of the prevalence and apoptotic profile of the CellSearch isolated CTCs and CTM from SCLC patients I and II. G: Displays EpCam positive stained CTM (left panel) and EpCam negative CTM (right panel) isolated by ISET from the same patient with NSCLC.