In vivo lymphatic circulating tumor cells and progression of metastatic disease

Mikyung Han, Julia Alex Watts, Azemat Jamshidi-Parsian, Urooba Nadeem, Mustafa Sarimollaoglu, Eric R. Siegel, Vladimir P. Zharov, Ekaterina I. Galanzha

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The dissemination of circulating tumor cells (CTCs) by lymph fluid is one of the key events in the development of tumor metastasis. However, little progress has been made in studying lymphatic CTCs (LCTCs). Here, we demonstrate the detection of L-CTCs in preclinical mouse models of melanoma and breast cancer using in vivo high-sensitivity photoacoustic and fluorescent flow cytometry. We discovered that L-CTCs are be detected in pre-metastatic disease stage. The smallest primary tumor that shed L-CTCs was measured as 0.094mm×0.094mm, its volume was calculated as 0.0004 mm3; and its productivity was estimated as 1 L-CTC per 30 minutes. As the disease progressed, primary tumors continued releasing L-CTCs with certain individual dynamics. The integrated assessment of lymph and blood underlined the parallel dissemination of CTCs at all disease stages. However, the analysis of links between L-CTC counts, blood CTC (B-CTC) counts, primary tumor size and metastasis did not reveal statistically significant correlations, likely due to L-CTC heterogeneity. Altogether, our results showed the feasibility of our diagnostic platform using photoacoustic flow cytometry for preclinical L-CTC research with translational potential. Our findings also demonstrated new insights into lymphatic system involvement in CTC dissemination. They help to lay the scientific foundation for the consideration of L-CTCs as prognostic markers of metastasis and to emphasize the integrative assessment of lymph and blood.

Original languageEnglish (US)
Article number2866
Pages (from-to)1-18
Number of pages18
Issue number10
StatePublished - Oct 2020
Externally publishedYes


  • Circulating tumor cells
  • In vivo flow cytometry
  • Lymphatic vessels
  • Lymphography
  • Marker
  • Metastasis
  • Personalized prognosis
  • Photoacoustics
  • Sentinel lymph node

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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