Circulating Tumor Cells in Pulmonary Venous Blood of Primary Lung Cancer Patients Yoshitomo Okumura, MD, Fumihiro Tanaka, MD, PhD, Kazue Yoneda, Masaki.

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Circulating Tumor Cells in Pulmonary Venous Blood of Primary Lung Cancer Patients Yoshitomo Okumura, MD, Fumihiro Tanaka, MD, PhD, Kazue Yoneda, Masaki Hashimoto, MD, Teruhisa Takuwa, MD, Nobuyuki Kondo, MD, Seiki Hasegawa, MD, PhD The Annals of Thoracic Surgery Volume 87, Issue 6, Pages 1669-1675 (June 2009) DOI: 10.1016/j.athoracsur.2009.03.073 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Circulating tumor cells (CTCs) displayed by the CellSearch system. Cells captured with an anti–epithelial cell adhesion molecule (EpCAM) antibody were stained with (4′,6-diamidino-2-phenylindole (DAPI), an anti-cytokeratin antibody conjugated with phycoerythrin (CK-PE), and an anti-CD45 antibody conjugated with allophycocyanin (CD45-APC). Cells with round to oval morphology, a visible DAPI-positive nucleus, positive CK-PE staining in the cytoplasm, and negative staining for CD45-APC were judged as CTCs (cells 1, 2, and 3). Contaminated leukocytes were identified as DAPI+/CK−/CD45+ cells (cell 5). The CD45-positive cells were not judged as CTCs even when cells were positively stained for DAPI and CK-PE (cell 4). The Annals of Thoracic Surgery 2009 87, 1669-1675DOI: (10.1016/j.athoracsur.2009.03.073) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Distribution of circulating tumor cells (CTCs) in pulmonary venous blood (pvCTC count) in correlation with CTCs in peripheral blood (periCTC count). The number of CTCs per 7.5 mL of each blood sample was represented as the CTC count, and pvCTC count was shown in log10 scale. The Annals of Thoracic Surgery 2009 87, 1669-1675DOI: (10.1016/j.athoracsur.2009.03.073) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Distribution of circulating tumor cells (CTCs) in pulmonary venous blood (pvCTC) according to (A) histologic type, (B) pathologic (p) stage, (C) primary tumor site, (D) microscopic vessel invasion of primary tumor, and (E) microscopic lymphatic invasion of primary tumor. The number of CTCs per 7.5 mL of each pulmonary blood sample was represented as the pvCTC count, and pvCTC count was shown in log10 scale. The Annals of Thoracic Surgery 2009 87, 1669-1675DOI: (10.1016/j.athoracsur.2009.03.073) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions