Abstract
Circulating tumor cells (CTCs) are a promising source of clinical and biological cancer information and can be a material for liquid biopsy. However, detecting and capturing these cells remains a challenge. Various biological factors (e.g., cell surface proteins, cell size, deformability, or dielectrophoresis) have been applied to detect CTCs. Cancer cells dramatically change their characteristics during tumorigenesis and metastasis. Hence, defining a cell as malignant using such a parameter is difficult. Moreover, immortality is an essential characteristic of cancer cells. Telomerase elongates telomeres and plays a critical role in cellular immortality and is specifically activated in cancer cells. Thus, the activation of telomerase can be a good fingerprint for cancer cells. Telomerase cannot be recognized by antibodies in living cells because it is a nuclear enzyme. Therefore, telomerase-specific replication adenovirus, which expresses the green fluorescent protein, has been applied to detect CTCs. This review explores the overview of this novel technology and its application in gynecological cancers.
Highlights
Pathological examination of tumor tissue is an important step in medical practice
Epithelial cell surface markers, such as epithelial cell adhesion molecule (EpCAM) or mucin 1 (MUC1), or cytokeratin, which are keratin-containing intermediate filaments expressed in the cytoskeleton of epithelial cells, have been applied for this purpose
Among groups with high circulating tumor cells (CTCs), bevacizumab treatment was associated with a reduction in the risk of death and an increase progression-free survival (PFS), suggesting increased neovascularization and effectiveness of anti-angiogenic drug for such patients [26]
Summary
Pathological examination of tumor tissue is an important step in medical practice. there are inherent problems in this procedure. Epithelial cell surface markers, such as epithelial cell adhesion molecule (EpCAM) or mucin 1 (MUC1), or cytokeratin, which are keratin-containing intermediate filaments expressed in the cytoskeleton of epithelial cells, have been applied for this purpose. It is sometimes difficult to distinguish living cells from dead ones based on epithelial markers or cell size alone In this regard, epithelial markers or cell-size-dependent detection of CTCs is not a sufficiently valid procedure. Telomerase is a nucleoprotein complex that functions as an RNA-dependent DNA polymerase It elongates telomeres by adding TTAGGG repeats and is essential for cellular immortalization [9]. Detection of CTCs in Gynecological Cancer Using Conventional Technologies and Their Clinical Significance
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