Abstract
Circulating tumor cell (CTC) detection and numeration are becoming part of the common clinical practice, especially for breast, colon, and prostate cancer. However, their paucity in peripheral blood samples is an obstacle for their identification. Several groups have tried to improve CTC recovery rate by developing highly sensitive cellular and molecular detection methods. However, CTCs are still difficult to detect in peripheral blood. Therefore, their recovery rate could be increased by obtaining blood samples from vessels close to the drainage territories of the invaded organ, when the anatomical situation is favorable. This approach has been tested mostly during tumor resection surgery, when the vessels nearest to the tumor are easily accessible. Moreover, radiological (including echo‐guided based and endovascular techniques) and/or endoscopic routes could be utilized to obtain CTC samples close to the tumor in a less invasive way than conventional biopsies. The purpose of this article is to summarize the available knowledge on CTC recovery from blood samples collected close to the tumor (i.e., in vessels located in the drainage area of the primary tumor or metastases). The relevance of such an approach for diagnostic and prognostic evaluations will be discussed, particularly for pancreatic ductal adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, and non‐small‐cell lung cancer.
Highlights
Cancer diagnosis usually relies on information obtained using sequential procedures, including imaging data (CT, positron emission tomography (PET), magnetic emission imaging (MRI), ultrasonography, X-rays), changes in the levels of markers in bodily fluids, and mainly on the pathology examination of cancer cell or tissue samples, obtained by surgical biopsy or by fine-needle aspiration
This study showed that using an EpCAM-independent Circulating tumor cell (CTC) enrichment method followed by the functional EPISPOT assay significantly increased CTC detection rate to 55.4% in peripheral blood, and only slightly in mesenteric blood samples
Sabawata’s data suggested a shorter progression-free survival (PFS) when CTC clusters were present in the pulmonary vein, which was further studied by Murlidhar et al who showed that the presence of clusters in the pulmonary vein was a factor of poor prognosis (Murlidhar et al, 2017)
Summary
Cancer diagnosis usually relies on information obtained using sequential procedures, including imaging data (CT, PET, MRI, ultrasonography, X-rays), changes in the levels of markers in bodily fluids (e.g., blood, urine), and mainly on the pathology examination of cancer cell or tissue samples, obtained by surgical biopsy or by fine-needle aspiration (fine-needle aspiration cytology, FNAC). Tumor-proximal liquid biopsy such as infection, bleeding, or inflammation They carry the risk of seeding tumor cells around the sampling area. Detached cells can be cleared by interstitial fluids to lymph nodes, or into the veins draining the tissue, entering the circulation. They might extravasate at distant healthy tissues and contribute to metastasis formation. If the fraction of tumor cells in the biopsy is too low for pathology/molecular analyses, in tumors with strong desmoplastic reaction, repeated sampling is required, possibly delaying tumor management
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