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Adhesion of malignant cells to capillary endothelium.

To the Editor.— In a recent clinical report (235:2825, 1976), Li and Ross indicate that cells from solid tumors that escape into the general circulation either perish or remain dormant until they have achieved attachment to the endothelium of the capillary wall with the assistance of a fibrin clot. Our laboratory studies indicate this observation to be correct but incomplete. The known adhesive properties of fibrin and its continuous presence in the blood make it a logical agent to bind the malignant cells to the endothelium walls. However, it is important to point out that the adhesiveness of fibrin is a function of its surface-active properties. Thus, we have observed that a number of endogenous surface-active molecules (such as lecithin), as well as macromolecules (such as the mucopolysaccharides and albumin), are also capable of adsorbing onto cell surfaces and forming films that adhere readily to adjacent surfaces. These surfaces can