Circulating Tumor Cells in Colorectal Cancer: Past, Present, and Future Challenges
Circulating Tumor Cells in Colorectal Cancer: Past, Present, and Future Challenges
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DOI：
10.1007/s11864-010-0115-3
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发表时间：
2010-06-01
影响因子：
4.3
通讯作者：
Cohen, Steven J.
中科院分区：
文献类型：
--
作者：
Negin, Benjamin P.;Cohen, Steven J.
免疫磁分离和流式细胞术的最新进展使得循环肿瘤细胞（CTC）的检测和表征成为现实。这项技术已经证明了对乳腺癌和前列腺癌的预后意义。在本次综述中，我们将回顾有关结直肠癌 CTC 计数和鉴定的历史和当前数据。通过免疫磁性分离技术，可以可靠且可重复地识别 7.5 mL 外周血样本中 1 至 2 个细胞内的 CTC。前瞻性研究表明，每 7.5 mL 血液中存在千分之一 3 的 CTC，会对生存产生显着的不利影响。大约四分之一的转移性疾病患者属于预后不良组。此外，治疗时细胞数量的变化具有预后意义。虽然通过免疫磁性分离计数的 CTC 是 mCRC 患者的明确预后因素，但未来的挑战是研究治疗决策是否应受到其水平的影响。 mCRC 中的低细胞产量是目前回答这些重要临床问题的潜在障碍。 CTC 还可以通过流式细胞术、FISH 和 RT-PCR 进行分离和研究，从而可以实时评估肿瘤生物学。该领域的未来进展将改善这些细胞的检测和操作。 CTC 检测和表征的改进有望改进结直肠癌的手术和化疗治疗。
Recent advances in immunomagnetic separation and flow cytometry have made the detection and characterization of circulating tumor cells (CTC) a reality. This technology has already demonstrated prognostic significance in breast and prostate cancer. In the current review, we will review the historical and current data regarding the enumeration and identification of CTC in colorectal cancer. With immunomagnetic separation techniques, CTC can reliably and reproducibly be identified within 1 to 2 cells in a 7.5 mL sample of peripheral blood. Prospective studies have demonstrated a significant adverse impact on survival with the presence of a parts per thousand yen3 CTC per 7.5 mL blood. Approximately one quarter of patients with metastatic disease will be categorized in this poor prognosis group. In addition, change in number of cells on treatment has prognostic significance. While CTC enumerated through immunomagnetic separation are a clear prognostic factor for patients with mCRC, the future challenge is to study whether treatment decision-making should be impacted by their level. Low cell yield in mCRC is a potential hinderance to answering these important clinical questions at present. CTC can also be isolated and studied with flow cytometry, FISH, and RT-PCR, allowing real-time assessment of tumor biology. Future advances in this field will improve both the detection and manipulation of these cells. Improvements in detection and characterization of CTC will hopefully lead to refinement of the surgical and chemotherapeutic treatment of colorectal cancer.