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Osteosarcoma: improved survival with anticoagulation and amputation.

A study of warfarin anticoagulation as an adjunct to amputation of osteosarcomas was undertaken after finding dramatic results in experimental systems. Anticoagulation was started 7 days preoperatively, continued during the operation, and for up to six months postoperatively. Three of 21 (14%) non-anticoagulated control patients are alive at 5-11 years. Five of 9 (56%) of the anticoagulated patients remain alive 5-8 years. The presumed mechanism of increased survival is an inhibition of fibrin deposition around circulating tumor cells, thereby preventing their adherence to capillary endothelium to initiate metastasis formation.

Adolescent

Rhabdomyosarcoma presenting as carcinocythemia.

A case of rhabdomyosarcoma presenting with circulating tumour cells (carcinocythemia) is discussed. Tumor cells must be differentiated from leukemic cells or a leukemoid reaction. If the abnormal cells appear as syncytia, tumor should be strongly suspected. Cytochemical and/or histochemical stains should also be employed to differentiate tumor cells from hematopoietic cells.

Abdominal Neoplasms

Entry of metastatic malignant cells into the circulation from a subcutaneously growing myelogenous tumor.

The initial stage of metastasis formation, i.e., the entry of metastatic cells from a malignant subcutaneously growing myelogenous tumor into the circulation, was observed by means of transmission electron microscopy and scanning electron microscopy in Long-Evans rats. The transmural passage of malignant cells occurred through the walls of intact venules within the tumor. The malignant cell penetrated the endothelial cell body by making a temporary migration pore. The migration pore closed after the malignant cell entered the vascular lumen. The endothelial vascular lining remained continuous. The entry of malignant cells into the circulation was not the result of the general invasive and destructive properties of malignant tumor cells, but the consequence of a specific action of the tumor cells on the abluminal plasma membrane of the endothelium.

Animals

Destruction of circulating leukemia cells by phagocytosis in rats with myelogenous leukemia.

Acute myelogenous leukemia was induced in outbred Long-Evans rats by iv injections of leukemia cells from a subcutaneous tumor of Shay myelogenous leukemia. In rats with this leukemia the peripheral white blood cell (WBC) counts varied from 2.4 to 700 X 10(9)/liter. No differences were found in the bone marrow of the rats with the high WBC counts and that of rats with low WBC counts. This observation could explain the large variations in the number of circulating leukemia cells caused by differences in cell proliferation or delivery of cells into the circulation. Massive phagocytosis of leukemia cells occurred in animals with low WBC counts (less than 12 X 10(9)/liter) but not in animals with high WBC counts (greater than 150 X 10(9)/liter). This phagocytosis was directed against circulating leukemia cells. The main phagocytes were Kupffer's cells of the liver and macrophages of the spleen parenchyma. In addition, phagocytosis occurred in the spleens and bone marrow by intravascular macrophages, which were derived from extravascular sites. The endothelium of the postcapillary venules of the lymph nodes participated in the phagocytosis of circulating leukemia cells while continuing to be the locus of lymphocytic return from circulation to lymphatic parenchyma. The factors underlying the differences in macrophage activity between the rats with high and low WBC counts were unknown.

Animals

Tumor cell and host properties affecting the implantation and survival of blood-borne metastatic variants of B16 melanoma.

The organ distribution, arrest and survival of [125I]5-iodo-2'-deoxyuridine-labeled B16 melanoma cells with low (B16-F1) or high (B16-F10) metastatic potential were studied in a variety of normal and immunosuppressed syngeneic C57BL/6 mice, allogeneic A mice, and athymic nude NIH Swiss mice and their immunocompetent littermates. In addition, the in vitro aggregation properties of these tumor cells with various host organ cells in suspension were examined. Tumor cell arrest and survival following i.v. injection occurred at significantly higher rates in normal mice than in immune-depressed animals irrespective of strain, and, two weeks later, significantly more tumor colonies were found in the normal animals. In syngeneic or allogeneic animals, B16-F10 cells were arrested, survived and formed significantly more gross pulmonary tumors than B16-F1 cells. B16-F10 cells also aggregated in vitro with purified organ cells in suspension obtained from either syngeneic or allogeneic mice at a greater rate than B16-F1 cells. These results indicate that although host properties can affect the arrest and survival of circulating tumor emboli, they do not diminish or abolish the biological differences between the high and low metastatic variant B16 lines.

Animals

Myeloma cells: surface morphology as seen by scanning and transmission electron microscopy.

Cells from cultured murine myeloma cell lines and circulating leukemic plasma cells from two patients with generalized myeloma were studied by transmission and scanning electron microscopy. Both circulating and cultured cells exhibited consistent surface architectures. Microvilli and varying numbers of prominent blebs of different sizes were seen. The presence of surface blebs is a characteristic feature of secreting and nonsecreting myeloma cells.

Animals

The retention of circulating Walker-256 cells by Walker-256 tumours.

When Walker-256 cancer cells are injected into the portal veins of rats bearing Walker-256 tumours in their livers, the retention of the injected cancer cells by the tumours is considerably less than in the surrounding liver. After applying defined general criteria for "homing" phenomena to the data, it is concluded that compared with the liver, they demonstrate "antihoming". The observations are explained in terms of a deficient arrest process within the tumours.

Animals

Fibrinolytic activity of carcinoma of the colorectum.

Twenty patients with carcinoma, mostly of the colorectum, and five without malignant tumors who were used as controls, have been investigated to elucidate the relationship between tumor fibrinolytic activity and the release of circulating malignant cells. The nature of the tumor fibrinolytic activity has been considered. The most significant fibrinolytic activity was seen in blood draining from the tumors and was evident in 80 per cent. Circulating malignant cells were recovered from half the patients, and in those with significant blood fibrinolysis, recovery from the draining vein reached 89 per cent. The most undifferentiated tumors appeared to be more active and released more cells. Fibrinolytic activity of tumor tissue derives from inflammatory cells, dead tumor cells, avascular areas of the tumor and vascular endothelium and is probably proteolytic as well as purely fibrinolytic.

Colonic Neoplasms

[Lymph node pathology during dermatoses with circulating Sézary cells].

The authors reported 12 cases of patients with cutaneous involvment associated with the presence of Sezary cells in the peripheral blood and specific lymph node involvment. They classify these cases as partial, early segmentary types, advanced types and diffuse types. either leukemic or sarcomatous. This study, once again, suggests the possibility that the Sezary syndrome and mycosis fu ngoïdes are different expressions, either predominantly leukemic, or predominantly sarcomatous, of the same chronic malignant hemopathy of "T" lymphocytes.

Aged

[About tumor cell findings in the peripheral venous blood, blood-borne metastases and the incidence of thromboembolic episodes in patients with carcinoma of various localisations (author's transl)].

In a retrospective study the frequency distribution of positive screenings for free-floating cancer cells in the peripheral venous blood of patients with cancers of the larynx, the abdomen and the lung was related to the frequency of blood-borne metastases and the incidence of thromboembolic episodes within 5 years of observation. Carcinomas of the larynx which were characterized by a very low frequency of blood-borne metastases are related with a high level of free-floating cancer cells in the venous blood. In contrast abdominal and lung cancers have a high frequency of blood-borne metastases, but a lower level of circulating cancer cells in the peripheral venous blood. Also there is a significant correlation between the initial presence of circulating cancer cells and the incidence of thromboembolic episodes in patients with abdominal and lung cancers, in contrast to patient with cancers of the larynx who lack this coincidence. On the basis of our observation we assume that the circulating tumor cells of the patients with abdominal and lung cancers have a high stickiness, therefore displaying a strong tendency to attach to the vascular endothelium. Only lodged cancer cells are able to penetrate the vessel wall and to develop metastases in the interstitial tissue. Remote and more or less generalized effects of cancer on blood coagulation are observed. In certain instances a disseminated intravascular coagulation results, almost exclusively due to remote effects of clotting factors elaborated by cancer cells, sometimes leading to micro- or macrothrombosis.

Abdominal Neoplasms

Isolation and characterization of a neuroblastoma cell line from peripheral blood in a patient with disseminated disease.

Circulation in the blood stream of neuroblastoma cells was confirmed by establishment of a cell line from the peripheral blood of a child with disseminated disease. The morphologic, enzymatic, and chromosomal pattern of this cell line was similar to a cell line established from the primary tumor on a previous occasion. The peripheral blood smear did not demonstrate tumor cells but increased numbers of atypical monocytes; lymphoblasts were evident, which may have been unrecognized neuroblasts.

Acetylcholinesterase

Circulating tumor cells in murine myeloma.

BALB/c mice bearing subcutaneous ADJ-PC5 myelomas had hematologic findings suggestive of a preleukemic syndrome: thrombocytopenia, anemia, leukocytosis, and megakaryocytic hyperplasia. Six BALB/c myelomas were successfully transplanted sc by fragments or cell suspensions of spleens from mice bearing a subcutaneous tumor, though typical myeloma cells were difficult to visualize by light microscopy in these spleens. The fidelity of transmission of the ADJ-PC5 myeloma by this procedure was shown by the retention of idiotypic specificity of the immunoglobulin produced by the tumor in a radioimmunoassay. The tumorigenic cell that homed to the spleen was apparent as early as 8 days after sc transplantation of the myeloma. The spleens of tumor-bearing mice, however, could destroy or suppress the expansion or growth of a limited number of cells that had migrated to the spleens. Tumorigenic cells present in the peripheral circulation constituted 2-3% of the leukocytes. These cells, however, had reduced levels of the murine myeloma viral and cell-associated antigens, were difficult to detect by an indirect immunofluorescence assay, and did not rapidly divide in this environment, as indicated by the very low number of cells detected by autoradiography.

Animals

Arrest patterns of circulating lymphosarcoma cells in tumour-bearing mice as modified by previously injected cell suspensions.

The effects were determined of an initial i.v. injection of 0.2 ml suspensions of 125IUdR-labelled lymphosarcoma cells on the early arrest patterns of a second injection of cancer cells into tumour-bearing mice. The results indicate that interactions between the first injection and the host markedly affected the arrest pattern of the second dose in the lungs, but not the livers, of tumour-bearing animals. These observations are explained on the basis of the injected fluid volumes, which are considerable in mice, in relation to their total blood volumes of approximately 2 ml.

Animals

Some aspects of blood borne tumour emboli associated with thrombosis.

The ultrastructural morphology of the tumour cycle which has as one of its features the blood-borne tumour embolus associated with thrombosis is illustrated by examples of four phases. (1) The intrinsic vasculature of tumours influences the process of intravasation of tumour cells to form bloodborne emboli. Scanning electron microscopy of melanoma tumours reveals channels containing erythrocytes which are sinusoidal in appearance. (2) The reaction of the circulating blood to the villi and folds of tumour cells is to coat the surface with plasma proteins and platelets. Walker 256 carcinoma cells become encrusted with platelets following agitation with rat platelet rich plasma. (3) Damaged endothelium appears to provide a more secure adhesional site for the tumour embolus. Platelets on a damaged site may provide an active adhesional region for the platelets on the passing embolus. (4) Tumour cells migrate through the endothelial layer from the adherent embolus and can be held up at the level of the basement membrane of the endothelium.

Animals

Mismatch-introduced crRNA guided PCR-CRISPR/Cas12a platform improves EGFR point mutation detection in single tumor cell.

Dynamic monitoring of epidermal growth factor receptor (EGFR) mutations is essential for the early identification of resistance and treatment adaptation. Single-cell heterogeneity analysis is crucial for precision cancer medicine, yet sensitive and specific detection methods for individual tumor cells remain challenging. Here, we develop a PCR-CRISPR/Cas12a platform enhanced by the incorporation of mismatched base in crRNA at specific site for single-cell point mutation detection. This platform demonstrated high specificity and sensitivity, detecting point mutation at a frequency of 0.1% and in as low as 1.02 ng of genomic DNA, which represents an improvement over the amplification-refractory mutation system PCR (ARMS-PCR). Notably, the accuracy of the platform is highly consistent with next-generation sequencing (NGS), as evidenced by Kappa test values surpassing 0.9. By utilizing a conical-pore membrane with optimized porosity for single circulating tumor cell (CTC) enrichment, our platform enables point mutations detection in individual tumor cells, offering potential enhancements in precision and reliability for EGFR mutation analysis. This novel methodology holds potential for more accurate and personalized cancer treatment strategies.

Humans

[Laws of substrate supply, of cell kinetics and of therapy mechanisms in the intercapillary region of cancer tissue].

Up to now, the microtopography of glucose and O2 concentration in the intercapillary region of tumour tissue has been determined under the simplifying assumption that substrate consumption is constant up to the periphery of the envisaged cylindrical space around a capillary. The general diffusion field equation presented in this paper takes into account that substrate consumption is constant up to the periphery of the envisaged cylindrical space around a capillary. The general diffusion field equation presented in this paper takes into account that substrate consumption decreases in the unsaturated region of cancer cell glycolysis and respiration so that - compared to former computations - the critical supply radii needed for maintained proliferation increase by a factor of almost 1.8. With the aid of its general solution and the discussed parameters, the laws governing substrate supply, cell kinetics and therapy mechanisms in the intercapillary region of intact and treated tumour tissue are presented and discussed. The essential results there are as follows: - Even in case of hyperglycemia it is glucose supply (and not the O2 supply) which determines proliferation and proliferation rate. - Under the conditions of longtime-hyperglycemia (400 mg%), the tumour volume being accessible to the attack of cancerostatica or radiation, is almost three times as high as under standard conditions. - For glucose (and cancerostatica) the time constant for interactions between circulation and tumour tissue near the necrotic region is equal to or greater than 400 min. This is why stimulation of cancer cell glycolysis in the most therapy-resistant cancer cell portions (i. e., increased proliferation rate and tumour hyperacidification) can only be achieved if hyperglycemia is maintained for 24 hours or more. - Therapeutically treated cancer tissue is characterized by the discussed changes in the diffusion field of glucose and O2 as well as a drop in the interaction time constant for glucose.

Animals

Effect of primary treatment modality on the metastatic pattern of mammary carcinoma.

In animal tumor systems, all three major treatment modalities, surgery, radiotherapy, and chemotherapy, may increase the incidence of metastases in the presence of circulating viable tumor cells. In breast cancer patients, selected studies can be found which report an increased incidence of metastases after surgery, radiotherapy, or chemotherapy, but these effects appear to exert little influence on overall survival. Caution is advised in using systemic therapy prior to effective primary tumor cytoreductive treatment. Clinical trials in advanced local disease should be done to test this concern. Minimal surgery, loco-regional radiotherapy, and effective adjuvant systemic therapy may result in the improved survival of patients with breast cancer with minimal functional or cosmetic impairment.

Antineoplastic Agents

Bioassay of blood-born tumour cells on in vivo and in vitro systems.

Viability and biological integrity of tumour cells circulating in the blood were studied in an experimental system using bioassay methods. Results of subcutaneous and intravenous retransplantation as well as explantation of the blood obtained from tumour-bearing animals previously receiving intravenous inoculation of tumour cell suspension (Yoshida sarcoma, Walker 256 carcinosarcoma and DMBA-induced myeloid ascitic leukaemia), revealed that the tumour cells detected in the blood are not only viable at the time of their transportation in the blood-stream but are also in possession of biologic potentials to proliferate and establish metastatic growths in organs.

Animals