Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Athens, Greece.
Clin Chem. 2011 Sep;57(9):1242-55. doi: 10.1373/clinchem.2011.165068. Epub 2011 Jul 22.
Circulating tumor cell (CTC) analysis is a promising new diagnostic field for estimating the risk for metastatic relapse and metastatic progression in patients with cancer.
Different analytical systems for CTC isolation and detection have been developed as immunocytochemical and molecular assays, most including separation steps by size or biological characteristics, such as expression of epithelial- or cancer-specific markers. Recent technical advancements in CTC detection and characterization include methods based on multiplex reverse-transcription quantitative PCR and approaches based on imaging and microfilter and microchip devices. New areas of research are directed toward developing novel assays for CTC molecular characterization. QC is an important issue for CTC analysis, and standardization of micrometastatic cell detection and characterization methodologies is important for the incorporation of CTCs into prospective clinical trials to test their clinical utility. The molecular characterization of CTCs can provide important information on the molecular and biological nature of these cells, such as the status of hormone receptors and epidermal and other growth factor receptor family members, and indications of stem-cell characteristics. This information is important for the identification of therapeutic targets and resistance mechanisms in CTCs as well as for the stratification of patients and real-time monitoring of systemic therapies.
CTC analysis can be used as a liquid biopsy approach for prognostic and predictive purposes in breast and other cancers. In this review we focus on state-of-the-art technology platforms for CTC isolation, imaging, and detection; QC of CTC analysis; and ongoing challenges for the molecular characterization of CTCs.
循环肿瘤细胞（CTC）分析是一种很有前途的新诊断领域，可用于评估癌症患者发生转移复发和转移进展的风险。
已经开发出不同的 CTC 分离和检测分析系统，包括免疫细胞化学和分子检测法，大多数方法包括通过大小或生物学特征（例如上皮或癌症特异性标志物的表达）进行分离步骤。CTC 检测和特征分析的最新技术进展包括基于多重逆转录定量 PCR 的方法以及基于成像和微滤器和微芯片设备的方法。新的研究领域致力于开发用于 CTC 分子特征分析的新型检测方法。质量控制（QC）是 CTC 分析的一个重要问题，并且微转移细胞检测和特征化方法的标准化对于将 CTC 纳入前瞻性临床试验以测试其临床实用性非常重要。CTC 的分子特征分析可以提供有关这些细胞的分子和生物学性质的重要信息，例如激素受体和表皮及其他生长因子受体家族成员的状态，以及干细胞特征的指示。这些信息对于确定 CTC 中的治疗靶标和耐药机制以及对患者进行分层和实时监测全身治疗非常重要。
CTC 分析可作为用于预后和预测的液体活检方法，适用于乳腺癌和其他癌症。在这篇综述中，我们重点介绍了用于 CTC 分离、成像和检测的最新技术平台；CTC 分析的 QC；以及 CTC 分子特征分析的当前挑战。
