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用于循环肿瘤细胞分离的楔形微流控芯片及其在胃癌中的临床意义。

Wedge-shaped microfluidic chip for circulating tumor cells isolation and its clinical significance in gastric cancer.

机构信息

Department of Gastrointestinal Surgery & Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, No.169 Donghu Road, Wuchang District, Wuhan, 430071, China.

Hubei Key Laboratory of Tumor Biological Behaviors, No.169 Donghu Road, Wuchang District, Wuhan, 430071, China.

出版信息

J Transl Med. 2018 May 23;16(1):139. doi: 10.1186/s12967-018-1521-8.

Abstract

BACKGROUND

Circulating tumor cells (CTCs) have great potential in both basic research and clinical application for the managements of cancer. However, the complicated fabrication processes and expensive materials of the existing CTCs isolation devices, to a large extent, limit their clinical translation and CTCs' clinical value. Therefore, it remains to be urgently needed to develop a new platform for achieving CTCs detection with low-cost, mass-producible but high performance.

METHODS

In the present study, we introduced a novel wedge-shaped microfluidic chip (named CTC-ΔChip) fabricated by two pieces of glass through wet etching and thermal bonding technique for CTCs isolation, which achieved CTCs enrichment by different size without cell surface expression markers and CTCs identification with three-color immunocytochemistry method (CK+/CD45-/Nucleus+). We validated the feasibility of CTC-ΔChip for detecting CTCs from different types of solid tumor. Furthermore, we applied the newly-developed platform to investigate the clinical significance of CTCs in gastric cancer (GC).

RESULTS

Based on "label-free" characteristic, the capture efficiency of CTC-ΔChip can be as high as 93.7 ± 3.2% in DMEM and 91.0 ± 3.0% in whole blood sample under optimized conditions. Clinically, CTC-ΔChip exhibited the feasibility of detecting CTCs from different types of solid tumor, and it identified 7.30 ± 7.29 CTCs from 2 mL peripheral blood with a positive rate of 75% (30/40) in GC patients. Interestingly, we found that GC CTCs count was significantly correlated with multiple systemic inflammation indexes, including the lymphocyte count, platelet count, the level of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. In addition, we also found that both the positivity rate and CTCs count were significantly associated with multiple clinicopathology parameters.

CONCLUSIONS

Our novel CTC-ΔChip shows high performance for detecting CTCs from less volume of blood samples of cancer patients and important clinical significance in GC. Owing to the advantages of low-cost and mass-producible, CTC-ΔChip holds great potential of clinical application for cancer therapeutic guidance and prognostic monitoring in the future.

摘要

背景

循环肿瘤细胞(CTCs)在癌症的基础研究和临床应用中具有巨大的潜力。然而,现有的 CTCs 分离设备制造过程复杂,材料昂贵,在很大程度上限制了它们的临床转化和 CTCs 的临床价值。因此,开发一种新的平台来实现具有低成本、大规模生产但高性能的 CTCs 检测仍然是迫切需要的。

方法

在本研究中,我们介绍了一种新型楔形微流控芯片(命名为 CTC-ΔChip),该芯片由两块通过湿法刻蚀和热键合技术制造的玻璃片组成,用于 CTCs 的分离,它通过不同的尺寸实现了 CTCs 的富集,而无需细胞表面表达标志物,并通过三色免疫细胞化学方法(CK+/CD45-/Nucleus+)对 CTCs 进行鉴定。我们验证了 CTC-ΔChip 从不同类型实体瘤中检测 CTCs 的可行性。此外,我们应用新开发的平台研究了 CTCs 在胃癌(GC)中的临床意义。

结果

基于“无标记”的特点,在优化条件下,CTC-ΔChip 在 DMEM 中的捕获效率高达 93.7±3.2%,在全血样本中的捕获效率高达 91.0±3.0%。临床上,CTC-ΔChip 显示了从不同类型实体瘤中检测 CTCs 的可行性,它从 40 名 GC 患者的 2 mL 外周血中鉴定出 7.30±7.29 个 CTCs,阳性率为 75%(30/40)。有趣的是,我们发现 GC CTCs 计数与多种全身炎症指标显著相关,包括淋巴细胞计数、血小板计数、中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值。此外,我们还发现,阳性率和 CTCs 计数均与多个临床病理参数显著相关。

结论

我们的新型 CTC-ΔChip 显示出从癌症患者较少体积的血液样本中检测 CTCs 的高性能,并在 GC 中具有重要的临床意义。由于具有低成本和大规模生产的优势,CTC-ΔChip 在未来癌症治疗指导和预后监测的临床应用中具有巨大的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0538/5966930/4b1ab3c4d7f8/12967_2018_1521_Fig1_HTML.jpg

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