English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2014; 38(2) 143-150
Published on-line:
DOI:
Cellule tumorali circolanti come biopsia liquida della neoplasia
AUTHORS
1Laboratory of Rare Human Circulating Cells, Institute of Research in Biotherapy, University Medical Centre, Saint-Eloi Hospital, Montpellier, France
2Laboratory of Cell and Hormonal Biology, University Medical Centre, Arnaud de Villeneuve Hospital, Montpellier, France
3University Institute of Clinical Research UM1–EA2415–Epidemiology, Biostatistics and Public Health, Montpellier, France
4Department of Tumor Biology, Center of Experimental Medicine, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Traduzione a cura di Anna Carobene e Ferruccio Ceriotti
ABSTRACT
Circulating tumor cells: liquid biopsy of cancer
The detection and molecular characterization of circulating tumor cells (CTCs) are one of the most active areas of translational cancer research, with >400 clinical studies having included CTCs as a biomarker. The aims of research on CTCs include: a) estimation of the risk for metastatic relapse or metastatic progression (prognostic information), b) stratification and real-time monitoring of therapies, c) identification of therapeutic targets and resistance mechanisms, and d) understanding metastasis development in cancer patients. This review focuses on the technologies used for the enrichment and detection of CTCs. We outline and discuss the current technologies that are based on exploiting the physical and biological properties of CTCs. A number of innovative technologies to improve methods for CTC detection have recently been developed, including CTC microchips, filtration devices, quantitative reverse-transcription polymerase chain reaction assays, and automated microscopy systems. Molecular-characterization studies have indicated, however, that CTCs are very heterogeneous, a finding that underscores the need for multiplex approaches to capture all of the relevant CTC subsets. We therefore emphasize the current challenges of increasing the yield and detection of CTCs that have undergone an epithelial–mesenchymal transition. Increasing assay analytical sensitivity may lead, however, to a decrease in analytical specificity (e.g., through the detection of circulating normal epithelial cells). A considerable number of promising CTC-detection techniques have been developed in recent years. The analytical specificity and clinical utility of these methods must be demonstrated in large prospective multicenter studies to reach the high level of evidence required for their introduction into clinical practice.