Vojtechova Gabriela, Benesova Lucie, Belsanova Barbora, Minarikova Petra, Levy Miroslav, Lipska Ludmila, Suchanek Stepan, Zavoral Miroslav, Minarik Marek
Internal Clinic, 1st Faculty of Medicine, Charles University and Central Military Hospital, Czech Republic.
Center for Applied Genomics of Solid Tumors (CEGES), Genomac Research Institute, Czech Republic.
Adv Clin Exp Med. 2016 Nov-Dec;25(6):1273-1279. doi: 10.17219/acem/63824.
The presence of circulating tumor cells (CTC) has been reported in patients with advanced colorectal cancer. Monitoring CTC (also known as a liquid-biopsy) has recently become the center of interest for low-invasive monitoring of cancer progression and predictive biomarkers testing. Along with high-cost technology and a complex methodology, a straightforward method based on magnetic beads enrichment followed by RT-PCR is set to allow for routine CTC analysis in colorectal cancer patients.
The main purpose of this study was to evaluate the possibility of CTC detection in routine monitoring of patients starting before and continuing after surgery.
The investigated group consisted of 30 patients mainly in advanced stages of colorectal cancer. In all patients, CTC detection was performed prior to surgery, in a subset of 14 patients additional sampling was done during and after surgery. In all cases, peripheral blood was processed using AdnaTest ColonCancer kit, which relies on enriching CTCs using EpCAM-functionalized magnetic beads and subsequently identifying tumorspecific CEA, EGFR and GA733-2 mRNA transcripts.
Out of all the tested samples, CTC were found in one patient suffering from advanced disease with lung and liver metastases. There, however, the positive finding was confirmed in 3 consecutive samples acquired before, during and shortly after palliative R2 resection.
The presence of CTC may be used to observe post-operative disease development. Due to the overall low CTC detection, further technology development may be necessary before its universal applicability to manage colorectal cancer patients.
晚期结直肠癌患者体内已被报道存在循环肿瘤细胞（CTC）。监测CTC（也称为液体活检）最近已成为癌症进展低侵入性监测和预测生物标志物检测的关注焦点。除了高成本技术和复杂方法外，一种基于磁珠富集随后进行逆转录聚合酶链反应（RT-PCR）的直接方法有望用于结直肠癌患者的常规CTC分析。
本研究的主要目的是评估在手术前开始并在手术后持续的患者常规监测中检测CTC的可能性。
研究组由30例主要处于晚期的结直肠癌患者组成。所有患者在手术前均进行了CTC检测，14例患者的亚组在手术期间和手术后进行了额外采样。在所有情况下，外周血均使用AdnaTest结肠直肠癌检测试剂盒进行处理，该试剂盒依靠EpCAM功能化磁珠富集CTC，随后鉴定肿瘤特异性癌胚抗原（CEA）、表皮生长因子受体（EGFR）和GA733-2信使核糖核酸（mRNA）转录本。
在所有检测样本中，一名患有伴有肺和肝转移的晚期疾病患者检测到了CTC。然而，在姑息性R2切除术前、术中和术后不久采集的3份连续样本中证实了这一阳性结果。
CTC的存在可用于观察术后疾病发展。由于总体CTC检测率较低，在其普遍适用于管理结直肠癌患者之前可能需要进一步的技术开发。
