Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Cancer Immunol Immunother. 2013 May;62(5):931-9. doi: 10.1007/s00262-012-1387-1. Epub 2013 Jan 12.
Carcinomas (tumors of epithelial origin) are responsible for most of all new cancers in the industrialized countries. Due to the high mortality rate caused by the metastatic spread of aggressive cancer cells, there is an urgent demand in finding new biomarkers, which should detect early formation of metastases and monitor efficacy of systemic adjuvant therapy in a timely manner. It has been considered that the molecular analysis of cells which are shed from tumors into the blood system (circulating tumor cells (CTCs)) might provide new insights for the clinical management of cancer, probably far earlier than using traditional high-resolution imaging technologies. Clinical trials indicated that CTCs can be deployed for diagnostic, monitoring, and prognostic purposes. Furthermore, these cells are discussed to be suitable as predictive markers. In any case, identification of CTCs requires innovative and challenging technologies as detection methods should be specific, sensitive, standardized, and highly reproducible. Although many different approaches have been developed until now, only the CellSearch™ method has been cleared by the American Food and Drug Administration. Although the detection of CTCs has already shown to have a prognostic impact in many tumor entities including breast, prostate, lung and colon cancer, ongoing and future studies are aimed to explore whether CTCs can be used for an individual therapy decision making including novel immunotherapeutic approaches. This review discusses (1) different detection strategies for CTCs, (2) their clinical impact, and (3) the potential use of CTCs guiding the treatment of individual cancer patients.
癌（上皮来源的肿瘤）是造成工业化国家大多数新增癌症的原因。由于侵袭性癌细胞转移扩散导致的高死亡率，人们迫切需要寻找新的生物标志物，以便及时发现转移的早期形成并监测系统辅助治疗的效果。人们认为，对从肿瘤进入血液系统（循环肿瘤细胞 (CTC)）中脱落的细胞进行分子分析，可能为癌症的临床管理提供新的见解，这可能比使用传统高分辨率成像技术更早。临床试验表明，CTC 可用于诊断、监测和预后目的。此外，这些细胞被认为是合适的预测标志物。无论如何，CTC 的识别都需要创新和具有挑战性的技术，因为检测方法应该具有特异性、敏感性、标准化和高度可重复性。尽管迄今为止已经开发出许多不同的方法，但只有 CellSearch™方法已获得美国食品和药物管理局的批准。尽管 CTC 的检测已经在包括乳腺癌、前列腺癌、肺癌和结肠癌在内的许多肿瘤实体中显示出具有预后影响，但正在进行和未来的研究旨在探索 CTC 是否可用于个体化治疗决策，包括新的免疫治疗方法。这篇综述讨论了（1）CTC 的不同检测策略，（2）它们的临床影响，以及（3）CTC 指导个体癌症患者治疗的潜在用途。
