Payne Karl, Brooks Jill, Spruce Rachel, Batis Nikolaos, Taylor Graham, Nankivell Paul, Mehanna Hisham
Institute of Head and Neck Studies and Education, University of Birmingham, Birmingham B15 2TT, UK.
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK.
Cancers (Basel). 2019 Aug 5;11(8):1115. doi: 10.3390/cancers11081115.
Head and neck cancer (HNC) continues to carry a significant burden of disease both for patients and health services. Facilitating biomarker-led treatment decisions is critical to improve outcomes in this group and deliver therapy tailored to the individual tumour biological profile. One solution to develop such biomarkers is a liquid biopsy analysing circulating tumour cells (CTCs)-providing a non-invasive and dynamic assessment of tumour specific alterations in 'real-time'. A major obstacle to implementing such a test is the standardisation of CTC isolation methods and subsequent down-stream analysis. Several options are available, with a recent shift in vogue from positive-selection marker-dependent isolation systems to marker-independent negative-selection techniques. HNC single-CTC characterisation, including single-cell sequencing, to identify actionable mutations and gene-expression signatures has the potential to both guide the understanding of patient tumour heterogeneity and support the adoption of personalised medicine strategies. Microfluidic approaches for isolating CTCs and cell clusters are emerging as novel technologies which can be incorporated with computational platforms to complement current diagnostic and prognostic strategies. We review the current literature to assess progress regarding CTC biomarkers in HNC and potential avenues for future translational research and clinical implementation.
头颈癌（HNC）对患者和医疗服务而言仍是一项重大的疾病负担。推动以生物标志物为导向的治疗决策对于改善该群体的治疗效果以及提供针对个体肿瘤生物学特征的治疗至关重要。开发此类生物标志物的一种解决方案是进行液体活检，分析循环肿瘤细胞（CTC）——从而“实时”提供对肿瘤特异性改变的非侵入性动态评估。实施此类检测的一个主要障碍是CTC分离方法及后续下游分析的标准化。目前有多种选择，最近流行趋势已从依赖阳性选择标记的分离系统转向不依赖标记的阴性选择技术。对头颈癌单个CTC的表征，包括单细胞测序，以识别可操作的突变和基因表达特征，有可能既有助于理解患者肿瘤的异质性，又能支持个性化医疗策略的采用。用于分离CTC和细胞簇的微流控方法正作为新技术崭露头角，可与计算平台相结合，以补充当前的诊断和预后策略。我们回顾当前文献，以评估头颈癌中CTC生物标志物的进展以及未来转化研究和临床应用的潜在途径。
