Roche-Chus Joint Unit, Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.
Adv Exp Med Biol. 2020;1220:45-59. doi: 10.1007/978-3-030-35805-1_4.
The majority of deaths related to breast cancer are caused by metastasis. Understanding the process of metastasis is key to achieve a reduction on breast cancer mortality. Currently, liquid biopsies are gaining attention in this regard. Circulating tumor cells (CTCs), an important component of liquid biopsies, are cells shed from primary tumor that disseminate to blood circulation being responsible of distal metastasis. Hence, the study CTCs is a promising alternative to monitor the progress of metastasis disease and can be used for early diagnosis of cancers as well as for earlier assessment of cancer recurrence and therapy efficacy. Despite their clinical interest, CTC analysis is not recommended by oncology guidelines so far. The main reason is that there is no gold standard technology for CTCs isolation and most of the current technologies are not yet validated for clinical use. In this chapter we will focus on the most relevant technologies for CTC isolation based on their properties and depending on whether it is a positive or negative selection. We also describe each technology based on its potential use and its relevance in breast cancer. The chapter also contains a future perspective including the challenges and requirements of CTC detection.
大多数与乳腺癌相关的死亡都是由转移引起的。了解转移的过程是降低乳腺癌死亡率的关键。目前，液体活检在这方面受到关注。循环肿瘤细胞（CTC）是液体活检的一个重要组成部分，是从原发性肿瘤脱落并散布到血液循环中的细胞，是远处转移的罪魁祸首。因此，研究 CTC 是监测转移疾病进展的有前途的替代方法，可用于癌症的早期诊断以及更早地评估癌症复发和治疗效果。尽管它们具有临床意义，但迄今为止，肿瘤学指南不建议进行 CTC 分析。主要原因是目前还没有用于 CTC 分离的金标准技术，并且大多数当前技术尚未经过临床验证。在本章中，我们将根据其特性以及是阳性选择还是阴性选择，重点介绍最相关的 CTC 分离技术。我们还根据其潜在用途及其在乳腺癌中的相关性描述了每种技术。本章还包含对 CTC 检测的挑战和要求的未来展望。
