Relationship between hepatocellular carcinoma circulating tumor cells and tumor volume

Abstract

Background: Microfluidic platforms have demonstrated the ability to isolate rare circulating tumor cells from a wide variety of cancers. Our group has recently shown the ability to isolate circulating tumor cells (CTCs) from hepatocellular carcinoma (HCC) patients using a hematopoietic cell depletion microfluidic platform. However, the relationship of CTC generation and HCC progression is still not well understood. Tumor size is often used as a clinical prognostic factor, but there has been an inconsistent relationship of tumor size and metastatic recurrence. Characterizing the relationship of primary tumor size and CTCs would provide a better understanding of HCC tumor size and metastatic potential.

The Role of Circulating Tumor Cells in the Metastatic Cascade: Biology, Technical Challenges, and Clinical Relevance

“…Conversely, CTC number was significantly higher in small than large primary hepatocellular carcinoma [158]. This discrepancy may be due to the intrinsic heterogeneity of small volume tumors and to peri-tumoral inflammation that facilitates CTC entry in the blood stream [158].…”

“…Hence, low or non-invasive methods are required to improve the early diagnosis of cancer that is crucial to reduce the mortality of this disease. As CTCs are released into the blood circulation already by relatively small and undetectable primary tumors [158], their analysis is considered a minimally/non-invasive liquid biopsy that can be performed repeatedly to provide real-time information on solid cancer progression.…”

“…In patients with breast cancer, the correlation between tumor size, CTC counts, and survival revealed that CTC number is closely associated with the primary tumor size, the number of metastases, and PFS reduction [166]. Conversely, CTC number was significantly higher in small than large primary hepatocellular carcinoma [158]. This discrepancy may be due to the intrinsic heterogeneity of small volume tumors and to peri-tumoral inflammation that facilitates CTC entry in the blood stream [158].…”

Dangerous Liaisons: Circulating Tumor Cells (CTCs) and Cancer-Associated Fibroblasts (CAFs)

“…Almost a century later some studies emerged acknowledging the role of CTC clusters in metastasis [ 28 , 29 ]. It was in the 90´s that first studies isolated CTC clusters from the blood of patients with certain types of cancer, such as prostate, colorectal, breast, lung and clear cell renal cell and hepatocellular carcinoma [ 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. According to cancer animal models, the proportion of CTC clusters in the blood increases during cancer progression [ 37 ].…”

Irreversible Electroporation in Liver Cancers and Whole Organ Engineering

“…Although surveillance of high-risk patients and advances in treatment regimens are prolonging survival, long-term outcomes remain poor. For patients with early-stage disease, surgical resection and local therapies play an integral role in the treatment paradigm, while offering a bridge to liver transplant, which is considered curative [3,4,5,6,7,8,9]. However, increased nationwide demand and decreased supply of donor livers make organ procurement difficult, necessitating more effective therapies and alternate organ sources.…”