Pancreatic circulating tumor cells as a diagnostic adjunct in pancreatic cancer.

175 Background: Current diagnosis of pancreatic ductal adenocarcinoma (PDAC) relies upon image guided tissue sampling, which is expensive, inconvenient, and not without patient risk. Circulating tumor cells (CTCs) may improve our ability to diagnose PDAC, obtain pure molecular information uncontaminated by stromal cells, and potentially improve our ability to accurately stage patients at the time of diagnosis. Therefore, we evaluated CTCs as an adjunctive diagnostic biomarker of PDAC at the time of presentation. Methods: We performed a prospective analysis on 50 consecutive pre-treatment patients with either suspicion for, or recent diagnosis of PDAC who were referred to our UCLA Center for Pancreatic Diseases. 2 mL venous blood was evaluated for the presence and number of CTCs. Capture and enumeration was carried out with a novel microfluidic NanoVelcro technology enhanced by anti-EpCAM enrichment. CTCs were defined by size > 10 um and IHC staining pattern (DAPI+, CK+, and CD45-). Of note, KRAS mutationa...