Kakizaki Fumihiko, Oshiro Kyoichi, Enoki Yuya, Kawanishi Kana, Masuda Norikazu, Maekawa Hisatsugu, Matsubayashi Jun, Kawashima Masahiro, Miyoshi Hiroyuki, Takemura Yukitoshi, Obama Kazutaka
Department of Personalized Cancer Medicine, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-Ku, Kyoto 606-8507, Japan.
AFI Corporation, Medical Innovation Center, Building, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-Ku, Kyoto 606-8507, Japan.
Int J Mol Sci. 2025 Jun 10;26(12):5539. doi: 10.3390/ijms26125539.
Circulating tumor cells (CTCs) are multifaceted biomarkers with significant potential for precision oncology, offering opportunities to refine diagnoses and personalize treatments across various cancer types, including colorectal and breast cancer. CTC assays serve as reliable prognostic indicators, even during chemotherapy and/or molecularly targeted therapies. Notably, CTCs exhibit heterogeneity that gradually develops during carcinogenesis and becomes more pronounced in advanced disease stages. These intra- and intertumoral heterogeneities pose challenges, particularly when drug-resistant clones emerge following therapy. The dynamic behavior of CTCs provides valuable insights into treatment response and prognosis. Extensive efforts have led to the development of technologies for effective CTC isolation, accelerating their clinical implementation. While both CTC and circulating tumor DNA (ctDNA) tests offer prognostic value, they reflect different aspects of tumor biology: CTC counts indicate tumor progression, while ctDNA levels correlate with tumor burden. The combined analysis is expected to yield complementary insights. CTC tests are feasible in general hospitals and may serve as tumor markers comparable to, or even superior to, conventional markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) for colorectal cancer, and CA15-3 for breast cancer. Early incorporation of CTC tests into routine blood panels appears to be a rational and promising approach.
循环肿瘤细胞（CTC）是多面性的生物标志物，在精准肿瘤学方面具有巨大潜力，为包括结直肠癌和乳腺癌在内的各种癌症类型的诊断优化和治疗个性化提供了机会。即使在化疗和/或分子靶向治疗期间，CTC检测也可作为可靠的预后指标。值得注意的是，CTC表现出异质性，这种异质性在致癌过程中逐渐形成，并在疾病晚期变得更加明显。这些肿瘤内和肿瘤间的异质性带来了挑战，尤其是在治疗后出现耐药克隆时。CTC的动态行为为治疗反应和预后提供了有价值的见解。广泛的努力促使了有效CTC分离技术的发展，加速了它们的临床应用。虽然CTC和循环肿瘤DNA（ctDNA）检测都具有预后价值，但它们反映了肿瘤生物学的不同方面：CTC计数表明肿瘤进展，而ctDNA水平与肿瘤负荷相关。联合分析有望产生互补的见解。CTC检测在综合医院是可行的，并且对于结直肠癌，它可作为与癌胚抗原（CEA）和糖类抗原19-9（CA19-9）等传统标志物相当甚至更优的肿瘤标志物；对于乳腺癌，它可作为与CA15-3相当甚至更优的肿瘤标志物。尽早将CTC检测纳入常规血液检测似乎是一种合理且有前景的方法。
