Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
Adv Exp Med Biol. 2020;1220:81-91. doi: 10.1007/978-3-030-35805-1_6.
In metastatic breast cancer the role of circulating tumor cells (CTCs) enumeration for predicting clinical outcome is supported by many studies, most of them dealing with strictly epithelial cells. However, it is becoming clear that CTCs are a heterogeneous cell population characterized by plasticity and including also cells which have lost the epithelial phenotype. Here we review literature data on CTC heterogeneity both at phenotype and at molecular level and discuss the possible contribute of single cell analyses in precision medicine. We conclude with some remarks about the steps still necessary to achieve clinical validity and utility when considering also CTC phenotypic and molecular heterogeneity beyond a simple enumeration.
在转移性乳腺癌中，循环肿瘤细胞（CTC）计数预测临床结局的作用得到了许多研究的支持，其中大多数研究都针对严格的上皮细胞。然而，越来越明显的是，CTC 是一种具有可塑性的异质性细胞群体，其中还包括失去上皮表型的细胞。在这里，我们回顾了关于 CTC 表型和分子水平异质性的文献数据，并讨论了单细胞分析在精准医学中的可能贡献。我们最后还就考虑到 CTC 表型和分子异质性时，除了简单的计数之外，还需要进行哪些步骤才能实现临床有效性和实用性，提出了一些看法。
