Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
Cancer Research Institute, School of Basic Medical Science, Central South University, Changsha, Hunan, China.
J Cell Mol Med. 2018 Dec;22(12):5776-5786. doi: 10.1111/jcmm.13867. Epub 2018 Sep 26.
Accumulating evidence indicates that cancer cells spread much earlier than was previously believed. Recent technological advances have greatly improved the detection methods of circulating tumour cells (CTCs), suggesting that the dissemination of cancer cells into the circulation occurs randomly. Most CTCs die in circulation as a result of shear stress and/or anoikis. However, the persistence of disseminated tumour cells (DTCs) in the bone marrow is the result of interaction of DTCs with bone marrow microenvironment. DTCs in the bone marrow undergo successive clonal expansions and a parallel progression that leads to new variants. Compared to the CTCs, DTCs in the bone marrow have a unique signature, which displayed dormant, mesenchymal phenotype and osteoblast-like or osteoclast-like phenotype. The persistence of DTCs in the bone marrow is always related to minimal residual diseases (MRDs). This review outlines the difference between CTCs and DTCs in the bone marrow and describes how this difference affects the clinical values of CTCs and DTCs, such as metastasis and recurrence. We suggest that DTCs remaining in the bone marrow after therapy can be used as a superior marker in comparison with CTCs to define patients with an unfavourable prognosis and may therefore be a potential prognostic factor and therapeutic target for cancer therapy.
越来越多的证据表明，癌细胞的扩散比以前认为的要早得多。最近的技术进步极大地提高了循环肿瘤细胞（CTC）的检测方法，这表明癌细胞在循环中随机扩散。大多数 CTC 在循环中由于剪切力和/或失巢凋亡而死亡。然而，播散性肿瘤细胞（DTC）在骨髓中的持续存在是 DTC 与骨髓微环境相互作用的结果。骨髓中的 DTC 经历连续的克隆扩增和平行进展，导致新的变体。与 CTC 相比，骨髓中的 DTC 具有独特的特征，表现出休眠的间质表型和成骨样或破骨样表型。骨髓中 DTC 的持续存在总是与微小残留疾病（MRD）有关。这篇综述概述了骨髓中 CTC 和 DTC 之间的差异，并描述了这种差异如何影响 CTC 和 DTC 的临床价值，如转移和复发。我们建议，与 CTC 相比，治疗后残留在骨髓中的 DTC 可用作预后不良的优势标志物，因此可能成为癌症治疗的潜在预后因素和治疗靶点。
