Imaging Mass Cytometry as a method for improved diagnostics in patients with CUP syndrome and primary manifestation in the liver

Background The diagnostic algorithm for immunohistochemistry in patients presenting with metastatic cancer of unknown primary in the liver (CUP syndrome) remains a challenging and time-consuming process of several consecutively stained tumor markers. We created a panel for identification of tumor origin in one single staining process using Imaging Mass Cytometry.

Methods Formalin-fixed paraffin-embedded (FFPE) samples from liver metastasis tissue of 41 patients presenting with different entities of CUP syndrome were stained using a 43-marker panel addressing the most frequent tumor origins in CUP syndrome as well as identifying different subgroups of potentially targetable immune cell populations and receptors for targeted therapy. All 43 markers were stained in one single staining process and images were acquired using Imaging Mass Cytometry.

Results We were able to successfully establish a unique panel identifying origins of liver metastases e.g. mamma carcinoma, different tumors of intestinal origin or melanoma. Identification of most tumor origins was possible using the information of the acquired Imaging Mass Cytometry images. We also gained further information regarding immune cell populations and immune receptors of the different entities.

Conclusion Imaging Mass Cytometry presented itself as a promising approach for an improved and accelerated diagnostic algorithm in patients presenting with CUP syndrome regarding the identification of tumor origin.

Publication History

Article published online:
23 January 2024