Figure 1

Circulating hybrids cells out number circulating tumor cells in myriad of human cancer disease sites. (A) Anatomical location of 14 cancers evaluated for disseminated CTCs and CHCs. (B) Flow cytometry analysis of peripheral blood from patients with advanced stage colon, esophageal, lung, pancreatic and rectal adenocarcinomas as well as uveal melanoma (n = 5 patients per disease site) demonstrates CHCs (mean value, red bar) present at significantly higher levels compared to CTCs (mean value, grey bar) and healthy controls (mean value, n = 10). (C) Representative flow cytometry scatter plot of cytokeratin vs CD45 expression, CHCs (red box), CTCs (gray box) full gating schema in Fig. S1. (D) Isolation of CHCs from pancreatic adenocarcinoma identifies KRAS mutation in 9.1% of CHCs using ddPCR. (E) In situ immunofluorescence microscopy analysis of peripheral blood cells analyzed for detection of glial fibrillary acid protein (GFAP; red) and CD45 (white) expression in pediatric high-grade glioma and cytokeratin (CK; red) and CD45 (white) in breast adenocarcinoma, identify CHCs and rare CTCs. Scale bars 10 and 20 μm, respectively. (F) Immunofluorescence microscopy analysis of peripheral blood from patients (n = 5 per disease site) with ampullary carcinoma, breast, cholangiocarcinoma, head and neck squamous cell carcinoma, ovarian, prostate, high grade glioma (adult and pediatric) and pancreatic neuroendocrine tumors reveals CHCs (mean value, red bar) are present at significantly higher levels compared to CTCs (mean value, grey bar) and healthy controls. ***p < 0.00001; **p < 0.0001; *p < 0.05.