Rushton Amelia J, Nteliopoulos Georgios, Shaw Jacqueline A, Coombes R Charles
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
Leicester Cancer Research Centre, University of Leicester, Leicester LE2 7LX, UK.
Cancers (Basel). 2021 Feb 26;13(5):970. doi: 10.3390/cancers13050970.
Circulating tumour cells (CTCs) are the precursor cells for the formation of metastatic disease. With a simple blood draw, liquid biopsies enable the non-invasive sampling of CTCs from the blood, which have the potential to provide important insights into cancer detection and monitoring. Since gaining FDA approval in 2004, the CellSearch system has been used to determine the prognosis of patients with metastatic breast, prostate and colorectal cancers. This utilises the cell surface marker Epithelial Cell Adhesion Molecule (EpCAM), to enrich CTCs, and many other technologies have adopted this approach. More recently, the role of mesenchymal-like CTCs in metastasis formation has come to light. It has been suggested that these cells are more aggressive metastatic precursors than their epithelial counterparts; however, mesenchymal CTCs remain undetected by EpCAM-based enrichment methods. This has prompted the development of a variety of 'label free' enrichment technologies, which exploit the unique physical properties of CTCs (such as size and deformability) compared to other blood components. Here, we review a wide range of both immunocapture and label free CTC enrichment technologies, summarising the most significant advantages and disadvantages of each. We also highlight the important characteristics that technologies should possess for routine clinical use, since future developments could have important clinical implications, with the potential to direct personalised therapies for patients with cancer.
循环肿瘤细胞（CTCs）是转移性疾病形成的前体细胞。通过简单的采血，液体活检能够从血液中对CTCs进行非侵入性采样，这有可能为癌症检测和监测提供重要见解。自2004年获得美国食品药品监督管理局（FDA）批准以来，CellSearch系统已被用于确定转移性乳腺癌、前列腺癌和结直肠癌患者的预后。该系统利用细胞表面标志物上皮细胞粘附分子（EpCAM）来富集CTCs，许多其他技术也采用了这种方法。最近，间充质样CTCs在转移形成中的作用已被揭示。有人认为，这些细胞是比其上皮对应物更具侵袭性的转移前体；然而，基于EpCAM的富集方法仍无法检测到间充质CTCs。这促使人们开发了各种“无标记”富集技术，这些技术利用了CTCs与其他血液成分相比独特的物理特性（如大小和可变形性）。在此，我们综述了广泛的免疫捕获和无标记CTCs富集技术，总结了每种技术最显著的优缺点。我们还强调了这些技术在常规临床应用中应具备的重要特征，因为未来的发展可能具有重要的临床意义，有可能为癌症患者指导个性化治疗。
