Recent Progress in Enhanced Cancer Diagnosis, Prognosis, and Monitoring Using a Combined Analysis of the Number of Circulating Tumor Cells (CTCs) and Other Clinical Parameters

Abstract

Analysis of circulating tumor cells (CTCs) holds promise to diagnose cancer or monitor its development. Among the methods, counting CTC numbers in blood samples could be the simplest way to implement it. Nevertheless, its clinical utility has not yet been fully accepted. The reasons could be due to the rarity and heterogeneity of CTCs in blood samples that could lead to misleading results from assays only based on single CTC counts. To address this issue, a feasible direction is to combine the CTC counts with other clinical data for analysis. Recent studies have demonstrated the use of this new strategy for early detection and prognosis evaluation of cancers, or even for the distinguishment of cancers with different stages. Overall, this approach could pave a new path to improve the technical problems in the clinical applications of CTC counting techniques. In this review, the information relevant to CTCs, including their characteristics, clinical use of CTC counting, and technologies for CTC enrichment, were first introduced. This was followed by discussing the challenges and new perspectives of CTC counting techniques for clinical applications. Finally, the advantages and the recent progress in combining CTC counts with other clinical parameters for clinical applications have been discussed.

Circulating tumor cells help differentiate benign ovarian lesions from cancer before surgery: A literature review and proof of concept study using flow cytometry with fluorescence imaging

“…In addition, the definition of CTCs in the present study does not consider interstitial CTC, which are EpCAM negative. The prospect has been extensively discussed in the literature ( 57 , 58 ). It is commonly held that incorporating more cancer-specific surface markers, such as Her2, may enhance the detection rate of particular cancers.…”

Exploring the Immunological Profile in Breast Cancer: Recent Advances in Diagnosis and Prognosis through Circulating Tumor Cells

“…The presence of CTCs in TNBC is associated with a robust immunological response. Notably, targeting immune checkpoints, such as PD-L1, has emerged as a potential therapeutic avenue to enhance the immune response against CTCs in TNBC [160]. A recent systematic review has consolidated current insights on the correlation between CTC numbers and prognosis in metastatic TNBC (mTNBC).…”

Current Applications and Future Directions of Circulating Tumor Cells in Colorectal Cancer Recurrence

“…The reason might be the rarity and heterogeneity of CTCs in blood samples, and the use of CTCs alone as a single marker might lead to misleading results. One review article summarized and discussed the power of combining CTC counts with other clinical parameters (e.g., CTC, CTC subtypes, CEA, carbohydrate antigen-199 (CA-199)) in predicting CRC recurrence to improve the accuracy of cancer detection, prognostic evaluation, and therapeutic response monitoring in numerous malignancies, including CRC [128]. This section will discuss the value of CTC detection combined with different clinical parameters to increase the predictive power and risk evaluation performance for CRC recurrence (Figure 2).…”