Fig. 6

Case study of a patient with longitudinal CTC analysis. A: Computer tomography of the pelvis at diagnosis; B: computer tomography of the pelvis with local, PSA-negative progression of the primary; C: Histological confirmation of an adenocarcinoma of the prostate from a myelon-compressing bone metastasis (left HE staining, right NKX3.1 immunohistochemistry) and serum markers at the time of biopsy; D: Histological confirmation of a neuroendocrine (NE) transdifferentiation from the primarius (left HE staining, right synaptophysin immunohistochemistry) and serum markers at the time of biopsy; E: CTC count determined by CellSearch and the numbers of positive adenocarcinoma (AC) and NE markers after AdnaTest-based gene expression analysis at the first and the second timepoint of blood collection; F: serum markers lactate dehydrogenase (LDH), prostate specific antigen (PSA) and neuron-specific enolase (NSE) at the first and second timepoint of blood collection