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Circulating Tumor Cells

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Circulating Tumor Cells (CTCs)
Circulating Tumor Cells (CTCs) are tumor cells that detach from the primary tumor and travel in the bloodstream, spreading from the original tumor to other locations, leading to cancer metastasis. These cells exist in peripheral blood of cancer patients and detection of CTCs can help to determine the process of metastasis. In contrast with other blood cells, the number of CTCs is very rare in blood which makes them difficult to detect.

Yet developing ways to detect and analyze CTCs in blood is essential, because these cells can assist cancer research as well as clinical management for cancer patients. It plays a crucial role in diagnosis prognosis and monitoring of treatment.

In order to differentiate CTC from all other cells in the blood stream, the following characteristics are used to define CTCs:
  • Cell Markers:
    • Positive: cell-surface vimentin (CSV), EpCAM, Cytokeratin 8, Cytokeratin 18, or Cytokeratin 19
    • Negative: CD45
  • Morphology:
    • Size: at least 4 um x 4 um
    • Intracellular nucleus

Brief Introduction to CTC Research
The first step in conducting CTC research is to effectively isolate CTCs. Several methods are listed below:
  • Morphological methods, based on
    • Gradient density
    • Size
    • Biomorphology (Size & Deformability)
  • Immunological methods, including
    • Immunomagnetic methods
    • Microfluidic devices

CTCs can then be identified based on their characteristics using cytometric and nucleic-acid based approaches:
  • Cytometric methods
    • ICC (Immunocytochemistry )
    • IF (immunofluorescence)
    • FISH (fluorescence in situ hybridization)
    • Flow Cytometry
  • Nucleic acid method
    • RT-PCR


CytoQuest™ CR - Circulating Rare Cell Positive Enrichment & Retrieval System

Abnova’s CytoQuest™ CR is a non-invasive system for capture, enumeration, isolation and retrieval of circulating rare cells (CRCs). Three major subtypes of CRCs in translational research and clinical studies are circulating tumor cells (CTCs), circulating progenitor cells (CPCs), and circulating fetal cells (CFCs). A challenge for market adoption of CRCs is the efficient and reproducible identification, single cell isolation, and retrieval of highly pure and viable CRCs, with their applications supported by a wide repertoire of standardized, GMP grade bioreagents.

More CytoQuest™ CR Information
Product Showcase

Cancer Metastasis Ab   Circulating Tumor Cell Ab
2000+ antibodies targeting proteins related to cancer metastasis. 350+ antibodies for CSV, CD45, cytokeratins and EMT markers.

  • Highlights
  • 1. EMT circulating tumor cells detected by cell-surface vimentin are associated with prostate cancer progression.
    Satelli A, Batth I, Brownlee Z, Mitra A, Zhou S, Noh, H, Rojas CR, Li H, Meng QH, Li S. Oncotarget. 2017.
    2. Circulating tumor markers: harmonizing the yin and yang of CTCs and ctDNA for precision medicine.
    Batth IS, Mitra A, Manier S, Ghobrial IM, Menter D, Kopetz S, Li S. Ann Oncol. 2016 Dec 28(3): 468-77.
    3. Potential role of nuclear PD-L1 expression in cell-surface vimentin positive circulating tumor cells as a prognostic marker in cancer patients.
    Satelli A, Batth IS, Brownlee Z, Rojas C, Meng QH, Kopetz S, Li S. Sci Rep. 2016 Jul 1;6:28910.
    4. Cell-surface Vimentin: A mislocalized protein for isolating csVimentin+ CD133- novel stem-like hepatocellular carcinoma cells expressing EMT markers.
    Mitra A, Satelli A, Xia X, Cutrera J, Mishra L, Li S. Int J Cancer. 2015 Jul 15;137(2):491-6.
    5. EMT, CTCs and CSCs in tumor relapse and drug-resistance.
    Mitra A, Mishra L, Li S. Oncotarget. 2015 May 8;6(13):10697-711.
    6. Epithelial–Mesenchymal Transitioned Circulating Tumor Cells Capture for Detecting Tumor Progression.
    Satelli A, Mitra A, Brownlee Z, Xia X, Bellister S, Overman MJ, Kopetz S, Ellis LM, Meng QH, Li S. Clin Cancer Res. 2015 Feb 15;21(4):899-906.
    7. Circulating Tumor Cell Enumeration with a Combination of Epithelial Cell Adhesion Molecule– and Cell-Surface Vimentin–Based Methods for Monitoring Breast Cancer Therapeutic Response.
    Satelli A, Brownlee Z, Mitra A, Meng QH, Li S. Clin Chem. 2015 Jan 1;61(1):259-66.
    8. Vimentin in cancer and its potential as a molecular target for cancer therapy.
    Satelli A, Li S. Cell Mol Life Sci. 2011 Sep;68(18):3033-46.


  • Technology
  • 1. Microdevice for the isolation and enumeration of cancer cells from blood.
    Tan SJ, Lakshmi RL, Chen P, Lim WT, Yobas L, Lim CT. Biosens Bioelectron. 2010 Dec 15;26(4):1701-5.
    2. Versatile label free biochip for the detection of circulation tumor cells from peripheral blood in cancer patients.
    Tan SJ, Yobas L, Lee GY, Ong CN, Lim CT. Biomed Microdevices. 2009 Aug;11(4):883-92.


  • Translational Research
  • 1. Epithelial-mesenchymal transition and cell cooperativity in metastasis.
    Tsuji T, Ibaragi S, Hu GF. Cancer Res. 2009 Sep 15;69(18):7135-9.
    2. Molecular aspects of tumor cell migration and invasion.
    Bozzuto G, Ruggieri P, Molinari A. Ann Ist Super Sanita. 2010;46(1):66-80.
    3. Stem cell and epithelial-mesenchymal transition markers are frequently overexpressed in circulating tumor cells of metastatic breast cancer patients.
    Aktas B, Tewes M, Fehm T, Hauch S, Kimmig R, Kasimir-Bauer S. Breast Cancer Res. 2009;11(4):R46.


  • Preclinical Research
  • 1. Circulation tumor cells are transcriptionally similar to primary tumor in a murine prostate model.
    Helzer KT, Barnes HE, Day L, Harvey J, Billings PR, Forsyth A. Cancer Res. 2009 Oct 1;69(19):7860-6.
    2. Systemic spread is an early step in breast cancer.
    Husemann Y, Geigl JB, Schubert F, Musiani P, Meyer M, Burghart E, Forni G, Eils R, Fehm T, Riethmuller G, Klein CA. Cancer Cell. 2008 Jan;13(1):58-68.
    3. Novel therapies against aggressive and recurrent epithelial cancers by molecular targeting tumor-and metastasis-initiating cells and their progenies.
    Mimeault M, Batra SK. Anticancer Agents Med Chem. 2010 Feb;10(2):137-51.


  • Clinical Research
  • 1. Utilizing circulating tumor cells: challenges and pitfalls.
    Attard G, de Bono JS. Curr Opin Genet Dev. 2011 Feb;21(1):50-8.
    2. Circulating tumor cells: advances in detection methods, biological issues, and clinical relevance.
    Sun YF, Yang XR, Zhou J, Qiu SJ, Fan J, Xu Y. J Cancer Res Clin Oncol. 2011 Aug;137(8):1151-73.


  • Clinical Application (FDA Approved)
  • 1. Circulating tumor cells predict survival benefit from treatment in metastatic castration-resistant prostate cancer.
    de Bono JS, Scher HI, Montgomery RB, Parker C, Miller MC, Tissing H, Doyle GV, Terstappen LW, Pienta KJ, Raghavan D. Clin Cancer Res. 2008 Oct 1;14(19):6302-9.
    2. Circulating tumor cells, disease progression, and survival in metastatic breast cancer.
    Cristofanilli M. Semin Oncol. 2006 Jun;33(3 Suppl 9):S9-14.
    3. Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer.
    Cohen SJ, Punt CJ, Iannotti N, Saidman BH, Sabbath KD, Gabrail NY, Picus J, Morse M, Mitchell E, Miller MC, Doyle GV, Tissing H, Terstappen LW, Meropol NJ. J Clin Oncol. 2008 Jul 1;26(19):3213-21.


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