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In an effort to more accurately quantitate CTCs, we have synthesized fluorescent conjugates of 2 high\u2010affinity tumor\u2010specific ligands (folate\u2010AlexaFluor 488 and DUPA\u2010FITC) that bind tumor cells &gt;20\u2010fold more efficiently than fluorescent antibodies. Here we determine whether these tumor\u2010specific dyes can be exploited for quantitation of CTCs in peripheral blood samples from cancer patients. A CTC\u2010enriched fraction was isolated from the peripheral blood of ovarian and prostate cancer patients by an optimized density gradient centrifugation protocol and labeled with the aforementioned fluorescent ligands. CTCs were then quantitated by flow cytometry. CTCs were detected in 18 of 20 ovarian cancer patients (mean 222 CTCs\/ml; median 15 CTCs\/ml; maximum 3,118 CTCs\/ml), whereas CTC numbers in 16 gender\u2010matched normal volunteers were negligible (mean 0.4 CTCs\/ml; median 0.3 CTCs\/ml; maximum 1.5 CTCs\/ml; <jats:italic>p<\/jats:italic> &lt; 0.001, \u03c7<jats:sup>2<\/jats:sup>). CTCs were also detected in 10 of 13 prostate cancer patients (mean 26 CTCs\/ml, median 14 CTCs\/ml, maximum 94 CTCs\/ml) but not in 18 gender\u2010matched healthy donors (mean 0.8 CTCs\/ml, median 1, maximum 3 CTC\/ml; <jats:italic>p<\/jats:italic> &lt; 0.0026, \u03c7<jats:sup>2<\/jats:sup>). Tumor\u2010specific fluorescent antibodies were much less efficient in quantitating CTCs because of their lower CTC labeling efficiency. Use of tumor\u2010specific fluorescent ligands to label CTCs in peripheral blood can provide a simple, accurate and sensitive method for determining the number of cancer cells circulating in the bloodstream. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ijc.23717","type":"journal-article","created":{"date-parts":[[2008,7,25]],"date-time":"2008-07-25T18:54:23Z","timestamp":1217012063000},"page":"1968-1973","source":"Crossref","is-referenced-by-count":126,"title":["Quantitation of circulating tumor cells in blood samples from ovarian and prostate cancer patients using tumor\u2010specific fluorescent ligands"],"prefix":"10.1002","volume":"123","author":[{"given":"Wei","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumith A.","family":"Kularatne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly R.","family":"Kalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franklyn G.","family":"Prendergast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Amato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George G.","family":"Klee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn C.","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Low","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,8,13]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"512","article-title":"Quantitation of cell shedding into efferent blood of mammary adenocarcinoma","volume":"35","author":"Butler TP","year":"1975","journal-title":"Cancer Res"},{"key":"e_1_2_5_3_2","first-page":"414","article-title":"Quantitative studies on cancer dissemination","volume":"29","author":"Donelli MG","year":"1969","journal-title":"Cancer Res"},{"key":"e_1_2_5_4_2","first-page":"997","article-title":"Quantitative relationships of intravascular tumor cells, tumor vessels, and pulmonary metastases following tumor implantation","volume":"34","author":"Liotta LA","year":"1974","journal-title":"Cancer Res"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196404)17:4<450::AID-CNCR2820170406>3.0.CO;2-2"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040766"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.140"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1995.13.5.1195"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.9.1914"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.12.2634"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.7.1432"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.3816\/CCC.2006.n.029"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2004.11.006"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.8.4589"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0404036101"},{"key":"e_1_2_5_16_2","first-page":"236","article-title":"Detecting prostate cancer with molecular markers: uPM3","volume":"7","author":"Freedland SJ","year":"2005","journal-title":"Rev Urol"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-03-0409"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008445604263"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6690778"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1385\/MO:18:1:33"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.86.8.2617"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/333858a0"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(76)90026-X"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.9.1188"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940501)73:9<2432::AID-CNCR2820730929>3.0.CO;2-S"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-199101000-00002"},{"key":"e_1_2_5_27_2","first-page":"557","article-title":"Trophoblast and ovarian cancer antigen LK26. 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