Intravasation and extravasation, which constitute key steps of tumor metastasis, damage blood vessel and result in increased endothelial cells in peripheral blood. Both increased circulating endothelial cell (CEC, CD146+) and CTC correlate to tumor metastasis. Co-staining with antibodies against additional markers, such as Her-2 and epithelial cell surface molecules, could be performed simultaneously as necessary.
Immunofluorescence staining of cells fixed on the Cytelligen coated CTC slide which prevents peeling off and minimizes background keeps good morphology for cells , and is convenient for long term storage. The immunostained cells are applicable for enumeration and single cell analysis performed by laser capture microdissection.