Abstract
Metastasis is the cause of most cancer deaths. Circulating tumour cells (CTCs) are cells released from the primary tumour into the bloodstream that are considered the main promoters of metastasis. Therefore, these cells are targets for understanding tumour biology and improving clinical management of the disease. Several techniques have emerged in recent years to isolate, detect, and characterise CTCs. As CTCs are a rare event, their study requires multidisciplinary considerations of both biological and physical properties. In addition, as isolation of viable cells may give further insights into metastatic development, cell recovery must be done with minimal cell damage. The ideal system for CTCs analysis must include maximum efficiency of detection in real time. In this sense, new approaches used to enrich CTCs from clinical samples have provided an important improvement in cell recovery. However, this progress should be accompanied by more efficient strategies of cell quantification. A range of biosensor platforms are being introduced into the technology for CTCs quantification with promising results. This review provides an update on recent progress in CTCs identification using different approaches based on sensor signaling.
Highlights
Dissemination of tumour cells is usually undetectable in patients by conventional histopathology examination
We have recently described the acquisition of a plasticity and stemness phenotype in circulating tumour cells (CTCs) from endometrial cancer patients, probably related to their ability to promote distant metastasis [66]
Several approaches have been developed in recent years to improve the efficiency of CTCs isolation and reduce the time needed for subsequent analysis
Summary
Dissemination of tumour cells is usually undetectable in patients by conventional histopathology examination. In addition to the clinical relevance inherent to the understanding of the process of metastasis, early detection of circulating tumour cells (CTCs) could be useful for the identification of patients who require additional systemic therapies after resection of the primary tumour. Inclusion of the sequential follow-up of CTCs in clinical trials could provide information in the early stages about the therapeutic efficacy of the drugs against the presence of metastatic tumour cells. After the isolation process, a step is required to identify CTCs with high specificity This step is normally tedious and time-consuming, using techniques such as PCR, immunofluorescence, or flow cytometry [15]. To solve these limitations, detection approaches using sensor technology are being combined with traditional CTCs isolation procedures. Review provides an update on recent progress in CTCs identification using different approaches based on sensor signalling
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