Abstract
Since individualized therapy becomes more and more important in the treatment of rectal cancer, an accurate and effective approach should be established in the clinical settings to help physicians to make their decisions. Circulating tumor cells (CTCs), originated from either primary or metastatic cancer, could provide important information for diagnosis and monitoring of cancer. However, the implication and development of CTCs are limited due to the extreme rarity of these tumor cells. In this study we fabricated a simple and high-performance microfluidic device, which exploited numerous filtered microchannels in it to enrich the large-sized target tumor cells from whole blood. A very high CTC capture efficiency (average recovery rate: 94%) was obtained in this device at the optimum flow rate of 0.5 mL/h and channel height of 5 µm. Additionally, we used this device for detecting CTCs in 60 patients with rectal cancer. The CTC counts of rectal cancer patients were significantly higher than those in healthy subjects. Furthermore, the CTC counts detected by this device were significantly higher than those by EpCAM bead-based method for rectal cancer patients with various stage. Especially, for localized rectal cancer patients, the positive rates of samples with more than 3 CTCs per 5 mL blood by use of microdevice vs. EpCAM-based ones were 100% vs. 47%, respectively. Thus, this device provides a new and effective tool for accurate identification and measurement of CTCs in patients with rectal cancer, and has broad potential in clinical practice.
Highlights
In recent years, the incidence of rectal cancer is dramatically increasing all over the world [1]
The detection of Circulating tumor cells (CTCs) would be expected to provide a powerful tool for cancer prognosis, diagnosis of minimal residual disease, assessment of tumor sensitivity to anticancer drugs, and application of individualized treatment [7]
One of the most commonly used methods of CTC detection is based upon the use of magnetic bead conjugated antibodies against epithelial tumor related surface antigens such as epithelial cell adhesion molecule (EpCAM) [9,10]
Summary
The incidence of rectal cancer is dramatically increasing all over the world [1]. One of the most commonly used methods of CTC detection is based upon the use of magnetic bead conjugated antibodies against epithelial tumor related surface antigens such as epithelial cell adhesion molecule (EpCAM) [9,10]. Some data suggested that epithelial antigen might be lost on CTCs due to the epithelial-mesenchymal transition (EMT), which was considered to be a crucial event in metastatic process [12,13]. This may be the main problem that restricts the wide application of EpCAM-based method in clinical practice
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