Detection and cultivation of circulating tumor cells in gastric cancer.

Circulating tumor cells (CTCs) are important targets for treatment and critical surrogate markers when evaluating cancer prognosis and therapeutic response. A sensitive methodology for detecting CTCs in gastric cancer (GC) patients is needed. In this study we demonstrate a device for enrichment and cultivation of CTCs. In total, 22 patients with GC, all candidates for surgery, were enrolled in the study. Peripheral blood samples were collected before surgery, and patients were re-evaluated within operation and divided into two groups: resectable and non-resectable GC. A new size-based separation test for enrichment and cultivation of CTCs was used (MetaCell(®)). In addition to cytomorphological analysis, gene expression of tumor associated genes (Cytokeratin-18, Cytokeratin-19, Cytokeratin-20, Cytokeratin-7, EPCAM, MUC1, HER2, EGFR) and of leukocyte markers (e.g. CD45, CD68) was tested in enriched CTC fractions. CTCs were detected in 59 % of the patients studied (n = 13/22). CTCs were detected in seven patients of the resection group (7/10, 70 %) and six of the non-resectable group (6/12, 50 %). Enrichment of the viable CTCs allowed subsequent successful cultivation in vitro. The cytomorphological characterization of the CTCs was a prerequisite of random gene expression testing in CTC-positive samples. In CTC-positive samples gene expression of cytokeratin 18 and 19 was elevated in comparison to the whole blood gene expression analysis. CTCs were found to be present in both resectable and non-resectable gastric cancer patients. The size-based separation platform for CTCs may be used for in vitro cultivation, as well as in subsequent molecular analysis if desired. The sensitivity of CTC-detection could be enhanced by the combination of cytomorphological and molecular analysis.

The added value of circulating tumor cells examination in ovarian cancer staging.

Delayed diagnosis of ovarian cancer (OC) is usually a cause of its high mortality. OC counts for one of the most aggressive gynecological malignancies. Noninvasive biomarkers may be used to help with diagnostic and treatment decisions in OC management. The incidence and clinical significance of occult OC cells (circulating tumor cells-CTCs) in the peripheral blood of patients with newly diagnosed or nondiagnosed OC at the time of surgical intervention were examined in our study. The objective of the study was to isolate and cultivate CTCs in OC patients (mainly stage IIIB-C) by a recently introduced size-based separation method (MetaCell(®)). CTCs were successfully isolated in patients with OC capturing cells with proliferation potential. The cells were enriched in good fitness, which enabled the short term in vitro culture of the CTCs. The CTCs may be used for further downstream applications (e.g. gene expression analysis) even if in the majority of the in vitro CTC cultures no confluence was reached. The CTCs were detected in 77 out of 118 patients (65.2%). CTC positivity was given to the relationship with different disease stage parameters with special focus on CA125 marker levels. The results show that the information on CTC presence may provide new and independent prognosis staging information to the patient description. Several interesting relationships of CA125, age and ascites presence are reported. As shown in our patient sample, patients with ascites tend to have higher CA125 levels, even if the CTCs were not found in the peripheral blood. It suggests that hematogenous dissemination is fully represented by the CTCs while lymphogenic dissemination is represented by elevated CA125. In this context, easy access to CTCs provided by the method applied in our study, both at the time of diagnosis and relapse, may become an increasingly valuable tool in future. This methodology may provide an opportunity for more personalized medicine where treatment for OC may be guided by information from an individual's CTC molecular profile.

Tanning salons in southwest Poland: a survey of safety standards and professional knowledge of the staff.

BACKGROUND: Nowadays, sunbeds are very popular worldwide; however--in the majority of countries, including Poland--there are no general guidelines and/or regulations for sunbed usage. PURPOSE: The aim of the study was to evaluate tanning salons in southwest Poland, paying special attention to safety regulations and basic professional knowledge of the staff members of these units. The hypothesis was put that tanning salons offer better skin and eye protection if their employees are more educated. METHODS: Fifty-five sunbed units were visited by the investigators, acting as potential clients. Information was obtained from the staff members in response to previously designed questionnaire. RESULTS: Employees of 41.8% of sunbed units had adequate knowledge of radiation used in their establishments. Goggles were provided in 72.7%, sunglasses in additional 25.5% of salons. Lotions with sunscreens were available in 41.8% of units. Brief medical history of the client was taken in 20% of units. No dermatological examination was performed. Tanning salons, where employed staff were well-orientated in ultraviolet radiation emitted in their units, significantly more frequently recommended usage of goggles and sunscreens (P = 0.0037 and P = 0.0033, respectively). Moreover, in these establishments sunscreens were more commonly available (P = 0.0029). CONCLUSIONS: The knowledge of staff members of tanning salons is poor and the eye and skin protection is not enough. The results point out the importance of the knowledge of the staff members in providing skin and eye protection.