Chapter 7.2

CellSearch Cell Interpretation Objectives and Resources

This presentation discusses the method of operation and evaluation of cells in the CellSearch® system.  The various biomarkers (CK-PE, DAPI, CD45-APC) are discussed as well as their appearance in tumor cells and non-epithelial cells.  Suspicious objects, computer noise, and other distractor objects are also evaluated.  The criteria for counting tumor cells, evaluating slide quality, and analyzing control samples are given as well.  (35 slides)


  • Explain the process used for identification of circulating tumor cells as used by the CellSearch® System.
  • Discuss the criteria for tumor cell identification
  • Compare/contrast the criteria of circulating tumor cells and non-circulating tumor cells
  • Discuss the common pitfalls in cell analysis
  • Explain the criteria for evaluating scan quality
  • List other techniques for evaluating circulating tumor cells


  1. Molecular Biology of the Cell, 4th ed. – Alberts et al. Garland Science 2002.  pp1324 – 1326.
  2. Essential Pathology, 3rd ed – Rubin.  Lippincott Williams and Williams 2001. pp 96-100.
  3. Addlar WJ, Matera J, Miller MC, et al. Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases.  Clinical Cancer Research (2004) vol 10, 6897-6904.
  4. Cristofanilli M, Budd GT, Ellis MJ et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. New England Journal of Medicine. (2004)351;8. 781-791.
  5. De Bono JS, Scher HI, Montgomery RB, et al. Circulating tumor cells predict survival benefit from treatment in metastatic castration –resistant prostate cancer.  Clinical Cancer Research (2008); 14:19. 6302-6309.
  6. Miller MC, Doyle GV, Terstappen WNN. Significance of circulating tumor cells detected by the CellSearch system in Patients with metastatic breast colorectal and prostate cancer. Journal of Oncology  (2010), Article ID 617421 pp 1-8.
  7. Marrinucci D, Bethel K, Lazar D, et al. Cytomorphology of Circulating Colorectal Tumor Cells: A Small Case Series. Human Pathology (2007) 38, 514-519.
  8. Hsieh, HB, Marrinucci D, Bethel K, et al. High speed detection of circulating tumor cells. Biosensors and Bioelectronics 21 (2006) 1893-1899.
  9. Leversha MA, Han J, Asgari Z, et al. Fluorescence in situ hybridization analysis of circulating tumor cells in metastatic prostate cancer. Clinical Cancer Research (2009); 15:6. 2091-2097.

Video:  -CellSearch®

* MD = Molecular Diagnostics:  Fundamentals, Methods, and Clinical Applications, Buckingham L, Flaws M, Davis, 2007