Vafaei Somayeh, Roudi Raheleh, Madjd Zahra, Aref Amir Reza, Ebrahimi Marzieh
Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Hemmat Street (Highway), Next to Milad Tower, Tehran, Iran.
Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
Cancer Cell Int. 2020 Jul 6;20:288. doi: 10.1186/s12935-020-01389-3. eCollection 2020.
At the present time, colorectal cancer (CRC) is still known as a disease with a high mortality rate. Theranostics are flawless scenarios that link diagnosis with therapy, including precision medicine as a critical platform that relies on the development of biomarkers particularly "liquid biopsy". Circulating tumor cells (CTCs) and tumor-derived exosomes (TDEs) in a liquid biopsy approach are of substantial importance in comparison with traditional ones, which cannot generally be performed to determine the dynamics of the tumor due to its wide restriction of range. Thus, recent attempts has shifted towards minimally noninvasive methods.
CTCs and TDEs, as significant signals emitted from the tumor microenvironment, which are also detectable in the blood, prove themselves to be promising novel biomarkers for cancer diagnosis, prognosis, and treatment response prediction. The therapeutic potential of them is still limited, and studies are at its infancy. One of the major challenges for the implementation of CTCs and TDEs which are new trends in translational medicine is the development of isolation and characterization; a standardizable approach. This review highlights and discusses the current challenges to find the bio fluids application in CRC early detection and clinical management.
Taken together, CTCs and TDEs as silent drivers of metastasis can serve in the management of cancer patient treatment and it is of the upmost importance to expand our insight into this subject. However, due to the limited data available from clinical trials, further validations are required before addressing their putative application in oncology.
目前，结直肠癌（CRC）仍然是一种死亡率很高的疾病。治疗诊断学是将诊断与治疗联系起来的完美方案，包括精准医学这一关键平台，其依赖于生物标志物尤其是“液体活检”的发展。与传统方法相比，液体活检方法中的循环肿瘤细胞（CTC）和肿瘤衍生外泌体（TDE）具有重要意义，传统方法由于范围限制广泛，通常无法用于确定肿瘤的动态变化。因此，最近的尝试转向了微创方法。
CTC和TDE作为从肿瘤微环境发出的重要信号，在血液中也可检测到，已证明它们是用于癌症诊断、预后和治疗反应预测的有前景的新型生物标志物。它们的治疗潜力仍然有限，相关研究尚处于起步阶段。实施CTC和TDE（转化医学的新趋势）的主要挑战之一是开发分离和表征方法，即一种标准化方法。本综述重点介绍并讨论了在结直肠癌早期检测和临床管理中寻找生物流体应用的当前挑战。
综上所述，CTC和TDE作为转移的沉默驱动因素可用于癌症患者治疗管理，深入了解这一主题至关重要。然而，由于临床试验可用数据有限，在探讨它们在肿瘤学中的假定应用之前，还需要进一步验证。
