Enumeration

CTC enumeration on the Epic Sciences platform consists of:

1. Slide prep: Upon receipt of patient blood sample, whole blood is lysed and nucleated cells are deposited on up to 12 microscope slides that are frozen at -80 ºC until analysis.
2. Cell staining and scanning: Slides are immunofluorescently stained and scanned by Epic’s rapid fluorescent scanning method, which images each nucleated cell.
3. CTC identification and biomarker analysis: A digital pathology algorithm, which includes protein expression and morphology, differentiates candidate CTCs from surrounding white blood cells (WBCs). CTCs are confirmed and classified into one of the following categories (1) Traditional CTCs, (2) CTC clusters, (3) CK(-) CTCs and (4) Apoptotic CTCs (see CTC basics to review these different classes of CTCs).