Abstract
Histopathological examination (biopsy) is the “gold standard” for the diagnosis of colorectal cancer (CRC). However, biopsy is an invasive method, and due to the temporal and spatial heterogeneity of the tumor, a single biopsy cannot reveal the comprehensive biological characteristics and dynamic changes of the tumor. Therefore, there is a need for new biomarkers to improve CRC diagnosis and to monitor and treat CRC patients. Numerous studies have shown that “liquid biopsy” is a promising minimally invasive method for early CRC detection. A liquid biopsy mainly samples circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), microRNA (miRNA) and extracellular vesicles (EVs). CTCs are malignant cells that are shed from the primary tumors and/or metastases into the peripheral circulation. CTCs carry information on both primary tumors and metastases that can reflect dynamic changes in tumors in a timely manner. As a promising biomarker, CTCs can be used for early disease detection, treatment response and disease progression evaluation, disease mechanism elucidation, and therapeutic target identification for drug development. This review will discuss currently available technologies for plasma CTC isolation and detection, their utility in the management of CRC patients and future research directions.
Highlights
Colorectal cancer (CRC) is the fourth deadliest cancer in the word, with almost one million deaths annually [1]
This study suggested for the first time that Circulating tumor cell (CTC) status can act as a predictive marker of local treatment benefits in patients with early breast cancer [67]
Conclusion and future development directions Decades of research have led to significant advancements in the clinical utility of CTCs in CRC patients
Summary
Colorectal cancer (CRC) is the fourth deadliest cancer in the word, with almost one million deaths annually [1]. A A fiber mat of electrospun nylon-6/PEO fibre for CTCs capture; b A ZnO nanowire coated polydimethylsiloxane pillar substrate with a gear structure; c Tumor-targeting molecule folic acid (FA) and magnetic nanoparticles (MNPs) coated engineered red blood cells (RBCs); d A microfluidic device integrated of dendrimer-mediated multivalent binding, a mixture of antibodies, and biomimetic cell rolling; e An ensemble-decision aliquot ranking (eDAR) microfluidic device using sequential sorting and flow stretching. Many studies have suggested that primary tumor cells need to undergo EMT before invading blood vessels and gaining metastatic ability These cells experience different degrees of EMT and gain several different subtypes, including the epithelial type, mesenchymal type or mixed type, and the expression of EpCAM on the surface of CTCs is downregulated to varying degrees, making it difficult for these heterogeneous cells to be enriched by EpCAM-dependent CTC capture technologies.
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