循环肿瘤细胞:不断发展的概念及其基于 EpCAM 的富集方法在基础和临床癌症研究中的不足。

Circulating tumour cells: the evolving concept and the inadequacy of their enrichment by EpCAM-based methodology for basic and clinical cancer research.

机构信息

Departments of Surgery

Gastroenterology and Hepatology.

出版信息

Ann Oncol. 2014 Aug;25(8):1506-16. doi: 10.1093/annonc/mdu018. Epub 2014 Mar 20.

Abstract

Increasing evidence suggests that circulating tumour cells (CTCs) are responsible for metastatic relapse and this has fuelled interest in their detection and quantification. Although numerous methods have been developed for the enrichment and detection of CTCs, none has yet reached the 'gold' standard. Since epithelial cell adhesion molecule (EpCAM)-based enrichment of CTCs offers several advantages, it is one of the most commonly used and has been adapted for high-throughput technology. However, emerging evidence suggests that CTCs are highly heterogeneous: they consist of epithelial tumour cells, epithelial-to-mesenchymal transition (EMT) cells, hybrid (epithelial/EMT(+)) tumour cells, irreversible EMT(+) tumour cells, and circulating tumour stem cells (CTSCs). The EpCAM-based approach does not detect CTCs expressing low levels of EpCAM and non-epithelial phenotypes such as CTSCs and those that have undergone EMT and no longer express EpCAM. Thus, the approach may lead to underestimation of the significance of CTCs, in general, and CTSCs and EMT(+) tumour cells, in particular, in cancer dissemination. Here, we provide a critical review of research literature on the evolving concept of CTCs and the inadequacy of their enrichment by EpCAM-based technology for basic and clinical cancer research. The review also outlines future perspectives in the field.

摘要

越来越多的证据表明,循环肿瘤细胞(CTCs)是转移复发的罪魁祸首,这激发了人们对其检测和定量的兴趣。尽管已经开发了许多方法来富集和检测 CTCs,但没有一种方法达到“黄金”标准。由于基于上皮细胞黏附分子(EpCAM)的 CTCs 富集具有多种优势,因此它是最常用的方法之一,并已适应高通量技术。然而,新出现的证据表明 CTCs 具有高度异质性:它们由上皮肿瘤细胞、上皮-间充质转化(EMT)细胞、杂交(上皮/EMT(+))肿瘤细胞、不可逆 EMT(+)肿瘤细胞和循环肿瘤干细胞(CTSCs)组成。基于 EpCAM 的方法无法检测到低水平表达 EpCAM 和非上皮表型的 CTCs,如 CTSCs 和那些经历 EMT 且不再表达 EpCAM 的 CTCs。因此,这种方法可能导致对 CTCs 总体意义的低估,特别是对 CTSCs 和 EMT(+)肿瘤细胞的低估,这在癌症扩散中尤为重要。在这里,我们对 CTCs 不断发展的概念以及基于 EpCAM 的技术对 CTCs 富集的不充分性的研究文献进行了批判性综述,为基础和临床癌症研究勾勒了该领域的未来前景。

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