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Yoshino T, Tanaka T, Nakamura S, Negishi R, Hosokawa M, Matsunaga T. Manipulation of a Single Circulating Tumor Cell Using Visualization of Hydrogel Encapsulation toward Single-Cell Whole-Genome Amplification. Anal Chem 2016; 88:7230-7. [DOI: 10.1021/acs.analchem.6b01475] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Tomoko Yoshino
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Tsuyoshi Tanaka
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Seita Nakamura
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Ryo Negishi
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Masahito Hosokawa
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Tadashi Matsunaga
- Division of Biotechnology
and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, 184-8588, Japan
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Forte VA, Barrak DK, Elhodaky M, Tung L, Snow A, Lang JE. The potential for liquid biopsies in the precision medical treatment of breast cancer. Cancer Biol Med 2016; 13:19-40. [PMID: 27144060 PMCID: PMC4850125 DOI: 10.28092/j.issn.2095-3941.2016.0007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Currently the clinical management of breast cancer relies on relatively few prognostic/predictive clinical markers (estrogen receptor, progesterone receptor, HER2), based on primary tumor biology. Circulating biomarkers, such as circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs) may enhance our treatment options by focusing on the very cells that are the direct precursors of distant metastatic disease, and probably inherently different than the primary tumor's biology. To shift the current clinical paradigm, assessing tumor biology in real time by molecularly profiling CTCs or ctDNA may serve to discover therapeutic targets, detect minimal residual disease and predict response to treatment. This review serves to elucidate the detection, characterization, and clinical application of CTCs and ctDNA with the goal of precision treatment of breast cancer.
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Affiliation(s)
- Victoria A Forte
- Department of Medicine, Division of Medical Oncology, University of Southern California (USC), Los Angeles, CA 90033, USA; USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
| | - Dany K Barrak
- USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; Department of Surgery, Division of Breast, Endocrine and Soft Tissue Surgery, USC, Los Angeles, CA 90033, USA
| | - Mostafa Elhodaky
- USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; Department of Stem Cell and Regenerative Medicine, USC, Los Angeles, CA 90033, USA
| | - Lily Tung
- USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; Department of Surgery, Division of Breast, Endocrine and Soft Tissue Surgery, USC, Los Angeles, CA 90033, USA
| | - Anson Snow
- Department of Medicine, Division of Medical Oncology, University of Southern California (USC), Los Angeles, CA 90033, USA; USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
| | - Julie E Lang
- USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA; Department of Surgery, Division of Breast, Endocrine and Soft Tissue Surgery, USC, Los Angeles, CA 90033, USA
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53
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Chen Y, Guo J, Muhammad H, Kang Y, Ary SK. CMOS-Compatible Silicon-Nanowire-Based Coulter Counter for Cell Enumeration. IEEE Trans Biomed Eng 2016; 63:311-5. [DOI: 10.1109/tbme.2015.2456190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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54
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Lorente D, Mateo J, de Bono JS. Molecular characterization and clinical utility of circulating tumor cells in the treatment of prostate cancer. Am Soc Clin Oncol Educ Book 2015:e197-203. [PMID: 24857103 DOI: 10.14694/edbook_am.2014.34.e197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Circulating tumor cells (CTCs) are rare cancer cells that can be detected in the blood of patients with solid malignancies. The Veridex CellSearch Assay was analytically and clinically validated, and has received U.S. Food and Drug Administration (FDA) clearance for the enumeration of CTCs in breast, colorectal, and prostate cancer. A number of alternative assays, with potential advantages, are currently undergoing clinical and/or analytic validation before their routine use can be established. In prostate cancer, high pretreatment CTC counts have been associated with worse survival, and changes in CTC counts in response to treatment have been established as indicators of response to treatment. Additional analyses are ongoing to establish the value of CTC counts as a surrogate of survival in prospective, phase III trials, which could influence the process of drug development and regulatory approval. Additionally, CTCs have a potential role in the molecular characterization of prostate cancer, serving as "liquid biopsies" to determine the molecular characteristics of the disease. The study of androgen receptor (AR) mutations or amplification, chromosomal rearrangements, or the determination of DNA repair biomarkers has been evaluated in clinical trials. CTCs have a wide range of potential applications, from their prognostic use in stratification of patients in clinical trials or the assessment of response to treatment, to the pharmacodynamic evaluation of novel agents, or the discovery and use of predictive biomarkers that can aid in the development of personalized medicine.
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Affiliation(s)
- David Lorente
- From the Division of Cancer Therapeutics and Division of Clinical Studies, The Institute of Cancer Research, Sutton, Surrey, UK; Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Joaquin Mateo
- From the Division of Cancer Therapeutics and Division of Clinical Studies, The Institute of Cancer Research, Sutton, Surrey, UK; Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Johann S de Bono
- From the Division of Cancer Therapeutics and Division of Clinical Studies, The Institute of Cancer Research, Sutton, Surrey, UK; Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
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55
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Vaidyanathan R, Dey S, Carrascosa LG, Shiddiky MJA, Trau M. Alternating current electrohydrodynamics in microsystems: Pushing biomolecules and cells around on surfaces. BIOMICROFLUIDICS 2015; 9:061501. [PMID: 26674299 PMCID: PMC4676781 DOI: 10.1063/1.4936300] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/10/2015] [Indexed: 05/08/2023]
Abstract
Electrohydrodynamics (EHD) deals with the fluid motion induced by an electric field. This phenomenon originally developed in physical science, and engineering is currently experiencing a renaissance in microfluidics. Investigations by Taylor on Gilbert's theory proposed in 1600 have evolved to include multiple contributions including the promising effects arising from electric field interactions with cells and particles to influence their behaviour on electrode surfaces. Theoretical modelling of electric fields in microsystems and the ability to determine shear forces have certainly reached an advanced state. The ability to deftly manipulate microscopic fluid flow in bulk fluid and at solid/liquid interfaces has enabled the controlled assembly, coagulation, or removal of microstructures, nanostructures, cells, and molecules on surfaces. Furthermore, the ability of electrohydrodynamics to generate fluid flow using surface shear forces generated within nanometers from the surface and their application in bioassays has led to recent advancements in biomolecule, vesicle and cellular detection across different length scales. With the integration of Alternating Current Electrohydrodynamics (AC-EHD) in cellular and molecular assays proving to be highly fruitful, challenges still remain with respect to understanding the discrepancies between each of the associated ac-induced fluid flow phenomena, extending their utility towards clinical diagnostic development, and utilising them in tandem as a standard tool for disease monitoring. In this regard, this article will review the history of electrohydrodynamics, followed by some of the recent developments in the field including a new dimension of electrohydrodynamics that deals with the utilization of surface shear forces for the manipulation of biological cells or molecules on electrode surfaces. Recent advances and challenges in the use of electrohydrodynamic forces such as dielectrophoresis and ac electrosmosis for the detection of biological analytes are also reviewed. Additionally, the fundamental mechanisms of fluid flow using electrohydrodynamics forces, which are still evolving, are reviewed. Challenges and future directions are discussed from the perspective of both fundamental understanding and potential applications of these nanoscaled shear forces in diagnostics.
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Affiliation(s)
- Ramanathan Vaidyanathan
- Centre for Personalised NanoMedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), Corner College and Cooper Roads (Bldg 75), The University of Queensland , Brisbane QLD 4072, Australia
| | - Shuvashis Dey
- Centre for Personalised NanoMedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), Corner College and Cooper Roads (Bldg 75), The University of Queensland , Brisbane QLD 4072, Australia
| | - Laura G Carrascosa
- Centre for Personalised NanoMedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), Corner College and Cooper Roads (Bldg 75), The University of Queensland , Brisbane QLD 4072, Australia
| | - Muhammad J A Shiddiky
- Centre for Personalised NanoMedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), Corner College and Cooper Roads (Bldg 75), The University of Queensland , Brisbane QLD 4072, Australia
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56
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Chen CC, Chen YA, Yao DJ. Centrifugal Filter Device for Detection of Rare Cells With Immuno-Binding. IEEE Trans Nanobioscience 2015; 14:864-9. [PMID: 26452287 DOI: 10.1109/tnb.2015.2485298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Many investigations have shown circulating tumor cells (CTCs) to serve as a significant biomarker of cancer progression and for cancer treatment. Multiple blood samples detection of CTCs during a course of treatment might facilitate a choice by a medical doctor of an effective drug and a treatment for particular patients. A simple and cost-effective method to identify the trend of decreasing CTCs during a treatment with various therapies is in great demand. A novel multilayer, concentric filter device combined with an immune-binding method enables the enrichment and detection of rare cells in a mass cell population with a separation based on size. Such separation implemented with a filter is among the most efficient, simple and inexpensive methods to isolate cells, but its main disadvantages are clogging, deformation of cells, and a requirement of a significant difference of size between targeted rare cells and normal cells. We designed a concentric filter device and an immune-binding method to create a significant size difference of target cells, and increased the efficiency of separation to identify rare cells with a simple miniature centrifuge in the laboratory. The enrichment of target rare cells from a mass cell population and the detection were demonstrated on mixing targeted MCF-7 blast cancer cells and Jurkat blood cells in ratio 1:1 000 000. The device is prospectively applicable for the detection of circulating tumor cells in a clinical application.
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57
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Han SI, Han KH. Electrical Detection Method for Circulating Tumor Cells Using Graphene Nanoplates. Anal Chem 2015; 87:10585-92. [PMID: 26402053 DOI: 10.1021/acs.analchem.5b03147] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This paper presents a microfluidic device for electrical discrimination of circulating tumor cells (CTCs) using graphene nanoplates (GNPs) as a highly conductive material bound to the cell surface. For two-step cascade discrimination, the microfluidic device is composed of a CTC-enrichment device and an impedance cytometry. Using lateral magnetophoresis, the CTC-enrichment device enriches rare CTCs from millions of background blood cells. Then, the impedance cytometry electrically identifies CTCs from the enriched sample, containing CTCs and persistent residual blood cells, based on the electrical impedance of CTCs modified by the GNPs. GNPs were used as a highly conductive material for modifying surface conductivity of CTCs, thereby improving the accuracy of electrical discrimination. The experimental results showed that a colorectal cancer cell line (DLD-1) spiked into peripheral blood was enriched by nearly 500-fold by the CTC-enrichment device. The phase of the electrical signal measured from DLD-1 cells covered by GNPs shifted by about 100° in comparison with that from normal blood cells, which allows the impedance cytometry to identify CTCs at a rate of 94% from the enriched samples.
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Affiliation(s)
- Song-I Han
- Department of Nano Science and Engineering, Center for Nano Manufacturing, Inje University , 607 Obang-dong, Gimhae, Gyongnam 621-749, Republic of Korea
| | - Ki-Ho Han
- Department of Nano Science and Engineering, Center for Nano Manufacturing, Inje University , 607 Obang-dong, Gimhae, Gyongnam 621-749, Republic of Korea
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58
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Zhang Z, Ramnath N, Nagrath S. Current Status of CTCs as Liquid Biopsy in Lung Cancer and Future Directions. Front Oncol 2015; 5:209. [PMID: 26484313 PMCID: PMC4588111 DOI: 10.3389/fonc.2015.00209] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/08/2015] [Indexed: 12/16/2022] Open
Abstract
Circulating tumor cells (CTCs) have garnered a lot of attention in the past few decades. Isolation of these rare cells from the billions of blood cells has been a challenge until recent times. With the advent of new sensitive technologies that permit live cell isolation and downstream genomic analysis, the existing paradigm of CTC research has evolved to explore clinical utility of these cells. CTCs have been identified as prognostic and pharmacodynamic biomarkers in many solid tumors, including lung cancer. As a means of liquid biopsy, CTCs could play a major role in the development of personalized medicine and targeted therapies. This review discusses the state of various isolation strategies, cell separation techniques and key studies that illustrate the application of liquid biopsy to lung cancer.
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Affiliation(s)
- Zhuo Zhang
- Department of Chemical Engineering, University of Michigan , Ann Arbor, MI , USA
| | - Nithya Ramnath
- Department of Internal Medicine, University of Michigan , Ann Arbor, MI , USA ; Veterans Administration Ann Arbor Healthcare System , Ann Arbor, MI , USA
| | - Sunitha Nagrath
- Department of Chemical Engineering, University of Michigan , Ann Arbor, MI , USA ; Translational Oncology Program, University of Michigan , Ann Arbor, MI , USA
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59
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Kim MS, Jo S, Park JT, Shin HY, Kim SS, Gurel O, Park SC. Method To Purify and Analyze Heterogeneous Senescent Cell Populations Using a Microfluidic Filter with Uniform Fluidic Profile. Anal Chem 2015; 87:9584-8. [DOI: 10.1021/acs.analchem.5b00445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Minseok S. Kim
- Well Aging Research
Center, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyenggi-do, Korea
- Department
of Biomedical Engineering, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, Korea
| | - Seonghyeon Jo
- Well Aging Research
Center, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyenggi-do, Korea
| | - Joon Tae Park
- Well Aging Research
Center, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyenggi-do, Korea
| | - Hyun Young Shin
- Well Aging Research
Center, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyenggi-do, Korea
| | - Sun Soo Kim
- R&D Solution Laboratory, Samsung Electronics, Ltd., Maetan3-dong, Youngtong-gu, Suwon-si, Gyeonggi-do, Korea
| | - Ogan Gurel
- Open Innovation
Group, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Korea
- Campus
D, 20, Yangpyeong-ro 21-gil, Yeongdeungpo-gu, Seoul, Korea
- Samsung Advanced Institute
of Health Sciences and Technology, Irwon-ro 81, Gangnam-gu, Seoul, Korea
| | - Sang Chul Park
- Well Aging Research
Center, Samsung Advanced Institute of Technology, Samsung Electronics,
Ltd., 130, Samsung-ro, Yeongtong-gu, Suwon-si, Gyenggi-do, Korea
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60
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Ren C, Han C, Fu D, Wang D, Chen H, Chen Y, Shen M. Circulating tumor cells in breast cancer beyond the genotype of primary tumor for tailored therapy. Int J Cancer 2015; 138:1586-600. [PMID: 26178386 DOI: 10.1002/ijc.29679] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/30/2015] [Indexed: 12/21/2022]
Abstract
Although TNM staging based on tumor, node lymph status and metastasis status-is the most widely used method in the clinic to classify breast cancer (BC) and assess prognosis, it offers limited information for different BC subgroups. Circulating tumor cells (CTCs) are regarded as minimal residual disease and are proven to have a strong relationship with BC. Detection of ≥5 CTCs per 7.5 mL in peripheral blood predicts poor prognosis in metastatic BC irrespective of other clinical parameters, whereas, in early-stage BC, detection of CK19(+) CTCs are also associated with poor prognosis. Increasing data and clinical trials show that CTCs can improve prognostic accuracy and help tailor treatment for patients with BC. However, heterogeneous CTCs in the process of an epithelial-mesenchymal transition (EMT) in BC makes it a challenge to detect these rare cells. Moreover, the genotypic and phenotypic features of CTCs are different from primary BC tumors. Molecular analysis of CTCs in BC may benefit patients by identifying those amenable to tailored therapy. We propose that CTCs should be used alongside the TNM staging system and the genotype of primary tumor to guide tailored BC diagnosis and treatment.
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Affiliation(s)
- Chuanli Ren
- Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
- Department of Epidemiology and Biostatistics, Ministry of Education (MOE) Key Laboratory of Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chongxu Han
- Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Deyuan Fu
- Breast Oncology Surgery, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Daxin Wang
- Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Hui Chen
- Geriatric Medicine Department, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Yong Chen
- Oncology Department, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Ming Shen
- Department of Physical Chemistry, Yangzhou University, Yangzhou, China
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61
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Lee SW, Hyun KA, Kim SI, Kang JY, Jung HI. Enrichment of circulating tumor cells using a centrifugal affinity plate system. J Chromatogr A 2014; 1373:25-30. [PMID: 25435456 DOI: 10.1016/j.chroma.2014.11.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 10/23/2014] [Accepted: 11/11/2014] [Indexed: 12/17/2022]
Abstract
Circulating tumor cells (CTCs) are defined as cells that have detached from a primary tumor and are circulating in the bloodstream. Their isolation and quantification is of great value for cancer prognoses and drug testing. Here, the development of a centrifugal affinity plate (CAP) system is described, in which centrifugal force and antibody-based capture are exploited to enrich CTCs on one plate and hematological cells on the other. The CAP is rotated to exert centrifugal force on the cells in a blood sample, quickly transporting them to the anti-epithelial adhesion molecule (EpCAM)-coated and anti-CD45-coated surface of the CAP to shorten the reaction time and increase the adhesion force between the tumor and blood cells and each antibody. The effect of a rotating process on cell capture was investigated, and the capture efficiency was demonstrated using blood samples from healthy donors spiked with human non-small cell lung cancer (NCI-H1650) and breast cancer (MCF-7) cells. The CAP system was capable of rapid isolation and identification of CTCs without the requirement for pretreatment of blood samples. Finally, the CAP system was tested to evaluate the detection efficiency of CTCs in the blood samples of breast cancer patients. The number of captured CTCs in only 1ml of blood varied from 6 to 10.
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Affiliation(s)
- Sung-Woo Lee
- School of Mechanical Engineering, Yonsei University, Seoul, South Korea; Center for Bio-Microsystems, Korea Institute of Science and Technology, Seoul, South Korea
| | - Kyung-A Hyun
- School of Mechanical Engineering, Yonsei University, Seoul, South Korea
| | - Seung-Il Kim
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Ji-Yoon Kang
- Center for Bio-Microsystems, Korea Institute of Science and Technology, Seoul, South Korea.
| | - Hyo-Il Jung
- School of Mechanical Engineering, Yonsei University, Seoul, South Korea.
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62
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Lee A, Park J, Lim M, Sunkara V, Kim SY, Kim GH, Kim MH, Cho YK. All-in-one centrifugal microfluidic device for size-selective circulating tumor cell isolation with high purity. Anal Chem 2014; 86:11349-56. [PMID: 25317565 DOI: 10.1021/ac5035049] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Circulating tumor cells (CTCs) have gained increasing attention owing to their roles in cancer recurrence and progression. Due to the rarity of CTCs in the bloodstream, an enrichment process is essential for effective target cell characterization. However, in a typical pressure-driven microfluidic system, the enrichment process generally requires complicated equipment and long processing times. Furthermore, the commonly used immunoaffinity-based positive selection method is limited, as its recovery rate relies on EpCAM expression of target CTCs, which shows heterogeneity among cell types. Here, we propose a centrifugal-force-based size-selective CTC isolation platform that can isolate and enumerate CTCs from whole blood within 30 s with high purity. The device was validated using the MCF-7 breast cancer cell line spiked in phosphate-buffered saline and whole blood, and an average capture efficiency of 61% was achieved, which is typical for size-based filtration. The capture efficiency for whole blood samples varied from 44% to 84% under various flow conditions and dilution factors. Under the optimized operating conditions, a few hundred white blood cells per 1 mL of whole blood were captured, representing a 20-fold decrease compared to those obtained using a commercialized size-based CTC isolation device. In clinical validation, normalized CTC counts varied from 10 to 60 per 7.5 mL of blood from gastric and lung cancer patients, yielding a detection rate of 50% and 38%, respectively. Overall, our CTC isolation device enables rapid and label-free isolation of CTCs with high purity, which should greatly improve downstream molecular analyses of captured CTCs.
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Affiliation(s)
- Ada Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST) , UNIST-gil 50, Ulsan, 689-798, Republic of Korea
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63
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Shen S, Ma C, Zhao L, Wang Y, Wang JC, Xu J, Li T, Pang L, Wang J. High-throughput rare cell separation from blood samples using steric hindrance and inertial microfluidics. LAB ON A CHIP 2014; 14:2525-38. [PMID: 24862501 DOI: 10.1039/c3lc51384j] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The presence and quantity of rare cells in the bloodstream of cancer patients provide a potentially accessible source for the early detection of invasive cancer and for monitoring the treatment of advanced diseases. The separation of rare cells from peripheral blood, as a "virtual and real-time liquid biopsy", is expected to replace conventional tissue biopsies of metastatic tumors for therapy guidance. However, technical obstacles, similar to looking for a needle in a haystack, have hindered the broad clinical utility of this method. In this study, we developed a multistage microfluidic device for continuous label-free separation and enrichment of rare cells from blood samples based on cell size and deformability. We successfully separated tumor cells (MCF-7 and HeLa cells) and leukemic (K562) cells spiked in diluted whole blood using a unique complementary combination of inertial microfluidics and steric hindrance in a microfluidic system. The processing parameters of the inertial focusing and steric hindrance regions were optimized to achieve high-throughput and high-efficiency separation, significant advantages compared with existing rare cell isolation technologies. The results from experiments with rare cells spiked in 1% hematocrit blood indicated >90% cell recovery at a throughput of 2.24 × 10(7) cells min(-1). The enrichment of rare cells was >2.02 × 10(5)-fold. Thus, this microfluidic system driven by purely hydrodynamic forces has practical potential to be applied either alone or as a sample preparation platform for fundamental studies and clinical applications.
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Affiliation(s)
- Shaofei Shen
- College of Science, Northwest A&F University, Yangling, Shaanxi 712100, China.
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64
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Hyun KA, Lee TY, Lee SH, Jung HI. Two-stage microfluidic chip for selective isolation of circulating tumor cells (CTCs). Biosens Bioelectron 2014; 67:86-92. [PMID: 25060749 DOI: 10.1016/j.bios.2014.07.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 01/26/2023]
Abstract
Over the past few decades, circulating tumor cells (CTCs) have been studied as a means of overcoming cancer. However, the rarity and heterogeneity of CTCs have been the most significant hurdles in CTC research. Many techniques for CTC isolation have been developed and can be classified into positive enrichment (i.e., specifically isolating target cells using cell size, surface protein expression, and so on) and negative enrichment (i.e., specifically eluting non-target cells). Positive enrichment methods lead to high purity, but could be biased by their selection criteria, while the negative enrichment methods have relatively low purity, but can isolate heterogeneous CTCs. To compensate for the known disadvantages of the positive and negative enrichments, in this study we introduced a two-stage microfluidic chip. The first stage involves a microfluidic magnetic activated cell sorting (μ-MACS) chip to elute white blood cells (WBCs). The second stage involves a geometrically activated surface interaction (GASI) chip for the selective isolation of CTCs. We observed up to 763-fold enrichment in cancer cells spiked into 5 mL of blood sample using the μ-MACS chip at 400 μL/min flow rate. Cancer cells were successfully separated with separation efficiencies ranging from 10.19% to 22.91% based on their EpCAM or HER2 surface protein expression using the GASI chip at a 100 μL/min flow rate. Our two-stage microfluidic chips not only isolated CTCs from blood cells, but also classified heterogeneous CTCs based on their characteristics. Therefore, our chips can contribute to research on CTC heterogeneity of CTCs, and, by extension, personalized cancer treatment.
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Affiliation(s)
- Kyung-A Hyun
- School of Mechanical Engineering, Yonsei University, 262 Seongsan-no, Seodaemun-gu, Seoul 120-749, Republic of Korea
| | - Tae Yoon Lee
- Materials & Components R&D Laboratory, LG Advanced Research Institute, Seoul 137-724, Republic of Korea
| | - Su Hyun Lee
- Nano Medical National Core Research Center, Yonsei University, 262 Seongsan-no, Seodaemun-gu, Seoul 120-749, Republic of Korea
| | - Hyo-Il Jung
- School of Mechanical Engineering, Yonsei University, 262 Seongsan-no, Seodaemun-gu, Seoul 120-749, Republic of Korea; Nano Medical National Core Research Center, Yonsei University, 262 Seongsan-no, Seodaemun-gu, Seoul 120-749, Republic of Korea.
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Yu ZTF, Yong KMA, Fu J. Microfluidic blood cell sorting: now and beyond. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2014; 10:1687-703. [PMID: 24515899 PMCID: PMC4013196 DOI: 10.1002/smll.201302907] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 12/16/2013] [Indexed: 05/15/2023]
Abstract
Blood plays an important role in homeostatic regulation with each of its cellular components having important therapeutic and diagnostic uses. Therefore, separation and sorting of blood cells hasa been of a great interest to clinicians and researchers. However, while conventional methods of processing blood have been successful in generating relatively pure fractions, they are time consuming, labor intensive, and are not optimal for processing small volume blood samples. In recent years, microfluidics has garnered great interest from clinicians and researchers as a powerful technology for separating blood into different cell fractions. As microfluidics involves fluid manipulation at the microscale level, it has the potential for achieving high-resolution separation and sorting of blood cells down to a single-cell level, with an added benefit of integrating physical and biological methods for blood cell separation and analysis on the same single chip platform. This paper will first review the conventional methods of processing and sorting blood cells, followed by a discussion on how microfluidics is emerging as an efficient tool to rapidly change the field of blood cell sorting for blood-based therapeutic and diagnostic applications.
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Affiliation(s)
- Zeta Tak For Yu
- Integrated Biosystems and Biomechanics Laboratory, University of
Michigan, Ann Arbor, Michigan, USA
- Department of Mechanical Engineering, University of Michigan, Ann
Arbor, Michigan, USA
| | - Koh Meng Aw Yong
- Integrated Biosystems and Biomechanics Laboratory, University of
Michigan, Ann Arbor, Michigan, USA
- Department of Mechanical Engineering, University of Michigan, Ann
Arbor, Michigan, USA
| | - Jianping Fu
- Integrated Biosystems and Biomechanics Laboratory, University of
Michigan, Ann Arbor, Michigan, USA
- Department of Mechanical Engineering, University of Michigan, Ann
Arbor, Michigan, USA
- Department of Biomedical Engineering, University of Michigan, Ann
Arbor, Michigan, USA
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66
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Chen TJ, Wu JK, Chang YC, Fu CY, Wang TP, Lin CY, Chang HY, Chieng CC, Tzeng CY, Tseng FG. High-efficiency rare cell identification on a high-density self-assembled cell arrangement chip. BIOMICROFLUIDICS 2014; 8:036501. [PMID: 24926391 PMCID: PMC4032428 DOI: 10.1063/1.4874716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 04/23/2014] [Indexed: 05/17/2023]
Abstract
Detection of individual target cells among a large amount of blood cells is a major challenge in clinical diagnosis and laboratory protocols. Many researches show that two dimensional cells array technology can be incorporated into routine laboratory procedures for continuously and quantitatively measuring the dynamic behaviours of large number of living cells in parallel, while allowing other manipulations such as staining, rinsing, and even retrieval of targeted cells. In this study, we present a high-density cell self-assembly technology capable of quickly spreading over 300 000 cells to form a dense mono- to triple-layer cell arrangement in 5 min with minimal stacking of cells by the gentle incorporation of gravity and peripheral micro flow. With this self-assembled cell arrangement (SACA) chip technology, common fluorescent microscopy and immunofluorescence can be utilized for detecting and analyzing target cells after immuno-staining. Validated by experiments with real human peripheral blood samples, the SACA chip is suitable for detecting rare cells in blood samples with a ratio lower than 1/100 000. The identified cells can be isolated and further cultured in-situ on a chip for follow-on research and analysis. Furthermore, this technology does not require external mechanical devices, such as pump and valves, which simplifies operation and reduces system complexity and cost. The SACA chip offers a high-efficient, economical, yet simple scheme for identification and analysis of rare cells. Therefore, potentially SACA chip may provide a feasible and economical platform for rare cell detection in the clinic.
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Affiliation(s)
- Tsung-Ju Chen
- Institute of NanoEngineering and MicroSystems, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Jen-Kuei Wu
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Yu-Cheng Chang
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Chien-Yu Fu
- Institute of Molecular Medicine, National Tsing Hua University, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Tsung-Pao Wang
- Institute of Molecular Medicine, National Tsing Hua University, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Chun-Yen Lin
- Institute of Molecular Medicine, National Tsing Hua University, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Hwan-You Chang
- Institute of Molecular Medicine, National Tsing Hua University, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Ching-Chang Chieng
- Department of Mechanical and Biomedical Engineering, City University of Hong Kong, Kowloon, Hong Kong
| | - Chung-Yuh Tzeng
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Fan-Gang Tseng
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan ; Academia Sinica, National Tsing Hua University, Taipei 115, Taiwan
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67
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Park JM, Kim MS, Moon HS, Yoo CE, Park D, Kim YJ, Han KY, Lee JY, Oh JH, Kim SS, Park WY, Lee WY, Huh N. Fully automated circulating tumor cell isolation platform with large-volume capacity based on lab-on-a-disc. Anal Chem 2014; 86:3735-42. [PMID: 24641782 DOI: 10.1021/ac403456t] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Full automation with high purity for circulating tumor cell (CTC) isolation has been regarded as a key goal to make CTC analysis a "bench-to-bedside" technology. Here, we have developed a novel centrifugal microfluidic platform that can isolate the rare cells from a large volume of whole blood. To isolate CTCs from whole blood, we introduce a disc device having the biggest sample capacity as well as manipulating blood cells for the first time. The fully automated disc platform could handle 5 mL of blood by designing the blood chamber having a triangular obstacle structure (TOS) with lateral direction. To guarantee high purity that enables molecular analysis with the rare cells, CTCs were bound to the microbeads covered with anti-EpCAM to discriminate density between CTCs and blood cells and the CTCs being heavier than blood cells were only settled under a density gradient medium (DGM) layer. To understand the movement of CTCs under centrifugal force, we performed computational fluid dynamics simulation and found that their major trajectories were the boundary walls of the DGM chamber, thereby optimizing the chamber design. After whole blood was inserted into the blood chamber of the disc platform, size- and density-amplified cancer cells were isolated within 78 min, with minimal contamination as much as approximately 12 leukocytes per milliliter. As a model of molecular analysis toward personalized cancer treatment, we performed epidermal growth factor receptor (EGFR) mutation analysis with HCC827 lung cancer cells and the isolated cells were then successfully detected for the mutation by PCR clamping and direct sequencing.
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Affiliation(s)
- Jong-Myeon Park
- Samsung Biomedical Research Institute, Samsung Advanced Institute of Technology, Samsung Electronics Company, Ltd. , 81 Irwon-Ro, Gangnam-Gu, Seoul 135-710, Republic of Korea
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68
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Yoon HJ, Kozminsky M, Nagrath S. Emerging role of nanomaterials in circulating tumor cell isolation and analysis. ACS NANO 2014; 8:1995-2017. [PMID: 24601556 PMCID: PMC4004319 DOI: 10.1021/nn5004277] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Circulating tumor cells (CTCs) are low frequency cells found in the bloodstream after having been shed from a primary tumor. These cells are research targets because of the information they may potentially provide about both an individual cancer as well as the mechanisms through which cancer spreads in the process of metastasis. Established technologies exist for CTC isolation, but the recent progress and future of this field lie in nanomaterials. In this review, we provide perspective into historical CTC capture as well as current research being conducted, emphasizing the significance of the materials being used to fabricate these devices. The modern investigation into CTCs initially featured techniques that have since been commercialized. A major innovation in the field was the development of a microfluidic capture device, first fabricated in silicon and followed up with glass and thermopolymer devices. We then specifically highlight the technologies incorporating magnetic nanoparticles, carbon nanotubes, nanowires, nanopillars, nanofibers, and nanoroughened surfaces, graphene oxide and their fabrication methods. The nanoscale provides a new set of tools that has the potential to overcome current limitations associated with CTC capture and analysis. We believe the current trajectory of the field is in the direction of nanomaterials, allowing the improvements necessary to further CTC research.
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69
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Chen Y, Li P, Huang PH, Xie Y, Mai JD, Wang L, Nguyen NT, Huang TJ. Rare cell isolation and analysis in microfluidics. LAB ON A CHIP 2014; 14:626-45. [PMID: 24406985 PMCID: PMC3991782 DOI: 10.1039/c3lc90136j] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Rare cells are low-abundance cells in a much larger population of background cells. Conventional benchtop techniques have limited capabilities to isolate and analyze rare cells because of their generally low selectivity and significant sample loss. Recent rapid advances in microfluidics have been providing robust solutions to the challenges in the isolation and analysis of rare cells. In addition to the apparent performance enhancements resulting in higher efficiencies and sensitivity levels, microfluidics provides other advanced features such as simpler handling of small sample volumes and multiplexing capabilities for high-throughput processing. All of these advantages make microfluidics an excellent platform to deal with the transport, isolation, and analysis of rare cells. Various cellular biomarkers, including physical properties, dielectric properties, as well as immunoaffinities, have been explored for isolating rare cells. In this Focus article, we discuss the design considerations of representative microfluidic devices for rare cell isolation and analysis. Examples from recently published works are discussed to highlight the advantages and limitations of the different techniques. Various applications of these techniques are then introduced. Finally, a perspective on the development trends and promising research directions in this field are proposed.
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Affiliation(s)
- Yuchao Chen
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Peng Li
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Po-Hsun Huang
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Yuliang Xie
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
- Department of Chemical Engineering, The Pennsylvania State University, University Park, PA 16802, USA
| | - John D. Mai
- Department of Mechanical and Biomedical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, PR China
| | - Lin Wang
- Ascent Bio-Nano Technologies Inc., State College, PA 16801, USA
| | - Nam-Trung Nguyen
- Queensland Micro- and Nanotechnology Centre, Griffith University, 170 Kessels Road, Brisbane 4111, Australia
| | - Tony Jun Huang
- Fax: 814-865-9974; Tel: 814-863-4209; Fax: 61-(0)7-3735-8021; Tel: 61-(0)7-3735-3921;
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70
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Hyun KA, Jung HI. Advances and critical concerns with the microfluidic enrichments of circulating tumor cells. LAB ON A CHIP 2014; 14:45-56. [PMID: 23982141 DOI: 10.1039/c3lc50582k] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Over the past two decades, circulating tumor cells (CTCs) have been widely recognized for their importance in clinical trials. While most enrichment methods for these cells have been conducted through the batch process due to their rarity in blood and the need for large sample volumes, the batch process leads to unavoidable cell loss. Given the heterogenetic features of CTCs, this cell loss may limit the validity of research that relies on the isolation of CTCs; such research includes cancer prognosis, diagnosis of minimal residual diseases, assessment of tumor sensitivity to anticancer drugs, and the personalization of anticancer therapies. Recent advances in microfluidic approaches have made it possible to enrich CTCs with a small degree of cell loss. In this review, we highlight several microfluidic-based positive and negative enrichment methods that are the subject of considerable research interest (e.g. EpCAM-dependent assay and EpCAM-independent assay) and suggest a microfluidic-based single cell analysis platform for the down-stream analysis of CTCs. We also discuss critical concerns and future directions for research.
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Affiliation(s)
- Kyung-A Hyun
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-no Seodaemun-gu, Seoul 120-752, South Korea.
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71
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de Wit S, van Dalum G, Terstappen LWMM. Detection of circulating tumor cells. SCIENTIFICA 2014; 2014:819362. [PMID: 25133014 PMCID: PMC4124199 DOI: 10.1155/2014/819362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 05/17/2014] [Indexed: 05/11/2023]
Abstract
The increasing number of treatment options for patients with metastatic carcinomas has created an accompanying need for methods to determine if the tumor will be responsive to the intended therapy and to monitor its effectiveness. Ideally, these methods would be noninvasive and provide quantitative real-time analysis of tumor activity in a variety of carcinomas. Assessment of circulating tumor cells shed into the blood during metastasis may satisfy this need. Here we review the CellSearch technology used for the detection of circulating tumor cells and discuss potential future directions for improvements.
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Affiliation(s)
- Sanne de Wit
- Department of Medical Cell BioPhysics, Faculty of Science and Technology, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Carre, Room C4437, Hallenweg 23, 7522 NH Enschede, The Netherlands
| | - Guus van Dalum
- Department of Medical Cell BioPhysics, Faculty of Science and Technology, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Carre, Room C4437, Hallenweg 23, 7522 NH Enschede, The Netherlands
| | - Leon W. M. M. Terstappen
- Department of Medical Cell BioPhysics, Faculty of Science and Technology, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Carre, Room C4437, Hallenweg 23, 7522 NH Enschede, The Netherlands
- *Leon W. M. M. Terstappen:
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72
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Shin JH, Lee MG, Choi S, Park JK. Inertia-activated cell sorting of immune-specifically labeled cells in a microfluidic device. RSC Adv 2014. [DOI: 10.1039/c4ra06296e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This paper demonstrates an inertia-activated cell sorting method to separate cells based on their surface protein expression by using inertial microfluidics.
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Affiliation(s)
- Joong Ho Shin
- Department of Bio and Brain Engineering
- Korea Advanced Institute of Science and Technology (KAIST)
- Daejeon 305-701, Republic of Korea
| | - Myung Gwon Lee
- Intellectual Discovery Co., Ltd
- Seoul 135-745, Republic of Korea
| | - Sungyoung Choi
- Department of Biomedical Engineering
- Kyung Hee University
- Gyeonggi-do 446-701, Republic of Korea
| | - Je-Kyun Park
- Department of Bio and Brain Engineering
- Korea Advanced Institute of Science and Technology (KAIST)
- Daejeon 305-701, Republic of Korea
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73
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Zhang H, Wang Y, Li Q, Zhang F, Tang B. A size amplified immune magnetic microbeads strategy in the rapid detection of circulating tumor cells. Chem Commun (Camb) 2014; 50:7024-7. [DOI: 10.1039/c4cc02342k] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A size amplified immune magnetic microbeads strategy for the combined use of membrane filtration and immune-magnetic separation in CTC detection.
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Affiliation(s)
- Hongyan Zhang
- College of Chemistry
- Chemical Engineering and Materials Science
- Collaborative Innovation Center of Functionalized Probes for Chemical Imaging
- Key Laboratory of Molecular and Nano Probes
- Ministry of Education
| | - Yanhong Wang
- College of Life Science
- Shandong Normal University
- Jinan, China
| | - Qingling Li
- College of Chemistry
- Chemical Engineering and Materials Science
- Collaborative Innovation Center of Functionalized Probes for Chemical Imaging
- Key Laboratory of Molecular and Nano Probes
- Ministry of Education
| | - Fumiao Zhang
- College of Life Science
- Shandong Normal University
- Jinan, China
| | - Bo Tang
- College of Chemistry
- Chemical Engineering and Materials Science
- Collaborative Innovation Center of Functionalized Probes for Chemical Imaging
- Key Laboratory of Molecular and Nano Probes
- Ministry of Education
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74
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Barradas AMC, Terstappen LWMM. Towards the Biological Understanding of CTC: Capture Technologies, Definitions and Potential to Create Metastasis. Cancers (Basel) 2013; 5:1619-42. [PMID: 24305653 PMCID: PMC3875957 DOI: 10.3390/cancers5041619] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 10/03/2013] [Accepted: 10/22/2013] [Indexed: 12/14/2022] Open
Abstract
Circulating Tumor Cells (CTC) are rare cells originated from tumors that travel into the blood stream, extravasate to different organs of which only a small fraction will develop into metastasis. The presence of CTC enumerated with the CellSearch system is associated with a relative short survival and their continued presence after the first cycles of therapy indicates a futile therapy in patients with metastatic carcinomas. Detailed characterization of CTC holds the promise to enable the choice of the optimal therapy for the individual patients during the course of the disease. The phenotype, physical and biological properties are however not well understood making it difficult to assess the merit of recent technological advancements to improve upon the capture of CTC or to evaluate their metastatic potential. Here we will discuss the recent advances in the classification of CTC captured by the CellSearch system, the implications of their features and numbers. Latest capture platforms are reviewed and placed in the light of technology improvements needed to detect CTC. Physical properties, phenotype, viability and proliferative potential and means to assess their proliferation and metastatic capacity will be summarized and placed in the context of the latest CTC capture platforms.
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Affiliation(s)
- Ana M C Barradas
- Department of Medical Cell Biophysics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, Enschede 7500AE, The Netherlands.
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75
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Kim MS, Kim J, Lee W, Cho SJ, Oh JM, Lee JY, Baek S, Kim YJ, Sim TS, Lee HJ, Jung GE, Kim SI, Park JM, Oh JH, Gurel O, Lee SS, Lee JG. A trachea-inspired bifurcated microfilter capturing viable circulating tumor cells via altered biophysical properties as measured by atomic force microscopy. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2013; 9:3103-3110. [PMID: 23401221 DOI: 10.1002/smll.201202317] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 10/15/2012] [Indexed: 06/01/2023]
Abstract
Circulating tumor cells (CTCs), though exceedingly rare in the blood, are nonetheless becoming increasingly important in cancer diagnostics. Despite this keen interest and the growing number of potential clinical applications, there has been limited success in developing a CTC isolation platform that simultaneously optimizes recovery rates, purity, and cell compatibility. Herein, a novel tracheal carina-inspired bifurcated (TRAB) microfilter system is reported, which uses an optimal filter gap size satisfying both 100% theoretical recovery rate and purity, as determined by biomechanical analysis and fluid-structure interaction (FSI) simulations. Biomechanical properties are also used to clearly discriminate between cancer cells and leukocytes, whereby cancer cells are selectively bound to melamine microbeads, which increase the size and stiffness of these cells. Nanoindentation experiments are conducted to measure the stiffness of leukocytes as compared to the microbead-conjugated cancer cells, with these parameters then being used in FSI analyses to optimize the filter gap size. The simulation results show that given a flow rate of 100 μL min(-1), an 8 μm filter gap optimizes the recovery rate and purity. MCF-7 breast cancer cells with solid microbeads are spiked into 3 mL of whole blood and, by using this flow rate along with the optimized microfilter dimensions, the cell mixture passes through the TRAB filter, which achieves a recovery rate of 93% and purity of 59%. Regarding cell compatibility, it is verified that the isolation procedure does not adversely affect cell viability, thus also confirming that the re-collected cancer cells can be cultured for up to 8 days. This work demonstrates a CTC isolation technology platform that optimizes high recovery rates and cell purity while also providing a framework for functional cell studies, potentially enabling even more sensitive and specific cancer diagnostics.
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Affiliation(s)
- Minseok S Kim
- POCT In Vitro Diagnostics Group, R&D Solution Group, Samsung Advanced Institute of Technology (SAIT), San 14, Nongseo-dong, Giheung-gu, Yongin-si, Gyeonggi-do, Korea.
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76
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Glynn MT, Kinahan DJ, Ducrée J. CD4 counting technologies for HIV therapy monitoring in resource-poor settings--state-of-the-art and emerging microtechnologies. LAB ON A CHIP 2013; 13:2731-2748. [PMID: 23670110 DOI: 10.1039/c3lc50213a] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Modern advancements in pharmaceuticals have provided individuals who have been infected with the human immunodeficiency virus (HIV) with the possibility of significantly extending their survival rates. When administered sufficiently soon after infection, antiretroviral therapy (ART) allows medical practitioners to control onset of the symptoms of the associated acquired immune deficiency syndrome (AIDS). Active monitoring of the immune system in both HIV patients and individuals who are regarded as "at-risk" is critical in the decision making process for when to start a patient on ART. A reliable and common method for such monitoring is to observe any decline in the number of CD4 expressing T-helper cells in the blood of a patient. However, the technology, expertise, infrastructure and costs to carry out such a diagnostic cannot be handled by medical services in resource-poor regions where HIV is endemic. Addressing this shortfall, commercialized point-of-care (POC) CD4 cell count systems are now available in such regions. A number of newer devices will also soon be on the market, some the result of recent maturing of charity-funded initiatives. Many of the current and imminent devices are enabled by microfluidic solutions, and this review will critically survey and analyze these POC technologies for CD4 counting, both on-market and near-to-market deployment. Additionally, promising technologies under development that may usher in a new generation of devices will be presented.
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Affiliation(s)
- Macdara T Glynn
- Biomedical Diagnostic Institute, National Centre for Sensor Research, School of Physical Sciences, Dublin City University, Dublin, Ireland.
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77
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Lee HJ, Oh JH, Oh JM, Park JM, Lee JG, Kim MS, Kim YJ, Kang HJ, Jeong J, Kim SI, Lee SS, Choi JW, Huh N. Efficient Isolation and Accurate In Situ Analysis of Circulating Tumor Cells Using Detachable Beads and a High-Pore-Density Filter. Angew Chem Int Ed Engl 2013; 52:8337-40. [DOI: 10.1002/anie.201302278] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/20/2013] [Indexed: 11/08/2022]
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78
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Lee HJ, Oh JH, Oh JM, Park JM, Lee JG, Kim MS, Kim YJ, Kang HJ, Jeong J, Kim SI, Lee SS, Choi JW, Huh N. Efficient Isolation and Accurate In Situ Analysis of Circulating Tumor Cells Using Detachable Beads and a High-Pore-Density Filter. Angew Chem Int Ed Engl 2013. [DOI: 10.1002/ange.201302278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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79
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Arya SK, Lim B, Rahman ARA. Enrichment, detection and clinical significance of circulating tumor cells. LAB ON A CHIP 2013; 13:1995-2027. [PMID: 23625167 DOI: 10.1039/c3lc00009e] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Circulating Tumor Cells (CTCs) are shed from primary or secondary tumors into blood circulation. Accessing and analyzing these cells provides a non-invasive alternative to tissue biopsy. CTCs are estimated to be as few as 1 cell among a few million WBCs and few billion RBCs in 1 ml of patient blood and are rarely found in healthy individuals. CTCs are FDA approved for prognosis of the major cancers, namely, Breast, Colon and Prostate. Currently, more than 400 clinical trials are ongoing to establish their clinical significance beyond prognosis, such as, therapy selection and companion diagnostics. Understanding the clinical relevance of CTCs typically involves isolation, detection and molecular characterization of cells, ideally at single cell level. The need for highly reliable, standardized and robust methodologies for isolating and analyzing CTCs has been widely expressed by clinical thought leaders. In the last decade, numerous academic and commercial technology platforms for isolation and analysis of CTCs have been reported. A recent market report highlighted the presence of more than 100 companies offering products and services related to CTCs. This review aims to capture the state of the art and examines the technical merits and limitations of contemporary technologies for clinical use.
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Affiliation(s)
- Sunil K Arya
- Bioelectronics Programme, Institute of Microelectronics, A*STAR (Agency for Science, Technology and Research), 11 Science Park Road, Singapore Science Park II, Singapore 117685.
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80
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Hyun KA, Jung HI. Microfluidic devices for the isolation of circulating rare cells: a focus on affinity-based, dielectrophoresis, and hydrophoresis. Electrophoresis 2013; 34:1028-41. [PMID: 23436295 DOI: 10.1002/elps.201200417] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 12/25/2012] [Accepted: 01/02/2013] [Indexed: 01/09/2023]
Abstract
Circulating rare cells have attracted interest because they can be good indicators of various types of diseases. For example, enumeration of circulating tumor cells is used for cancer diagnosis and prognosis, while DNA analysis or enumeration of nucleated red blood cells is useful for prenatal diagnosis or hypoxic anemia, and that of circulating stem cells to diagnose cancer metastasis. Isolation of these cells and their downstream analyses can provide significant information such as the origin and characteristics of a disease. Novel approaches based on microfluidics have many advantages, including the continuous process and integration with other components for analysis. For these reasons, a variety of microfluidic devices have been developed to isolate and characterize rare cells. In this article, we review several microfluidic devices, with a focus on affinity-based isolation (e.g. antigen-antibody reaction) and label-free separation (DEP and hydrophoresis).
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Affiliation(s)
- Kyung-A Hyun
- School of Mechanical Engineering, Yonsei University, Seoul, South Korea
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81
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Choi H, Kim KB, Jeon CS, Hwang I, Lee S, Kim HK, Kim HC, Chung TD. A label-free DC impedance-based microcytometer for circulating rare cancer cell counting. LAB ON A CHIP 2013; 13:970-7. [PMID: 23340965 DOI: 10.1039/c2lc41376k] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Quantification of circulating tumor cells (CTCs) in blood samples is believed to provide valuable evidence of cancer progression, cancer activity status, response to therapy in patients with metastatic cancer, and possible cancer diagnosis. Recently, a number of researchers reported that CTCs tend to lose their epithelial cell adhesion molecule (EpCAM) by an epithelial-mesenchymal transition (EMT). As such, label-free CTC detection methods are attracting worldwide attention. Here, we describe a label-free DC impedance-based microcytometer for CTCs by exploiting the difference in size between CTCs and blood cells. This system detects changes in DC impedance between two polyelectrolytic gel electrodes (PGEs) under low DC voltages. Using spiked ovarian cancer cell lines (OVCAR-3) in blood as a model system, we were able to count the cells using a microcytometer with 88% efficiency with a flow rate of 13 μl min(-1) without a dilution process. Furthermore, we examined blood samples from breast cancer patients using the cytometer, and detected CTCs in 24 out of 24 patient samples. Thus, the proposed DC impedance-based microcytometer presents a facile and fast way of CTC evaluation regardless of their biomarkers.
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Affiliation(s)
- Hyoungseon Choi
- Interdisciplinary Program, Bioengineering Major, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, Korea
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82
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Cima I, Wen Yee C, Iliescu FS, Phyo WM, Lim KH, Iliescu C, Tan MH. Label-free isolation of circulating tumor cells in microfluidic devices: Current research and perspectives. BIOMICROFLUIDICS 2013; 7:11810. [PMID: 24403992 PMCID: PMC3568085 DOI: 10.1063/1.4780062] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 12/17/2012] [Indexed: 05/04/2023]
Abstract
This review will cover the recent advances in label-free approaches to isolate and manipulate circulating tumor cells (CTCs). In essence, label-free approaches do not rely on antibodies or biological markers for labeling the cells of interest, but enrich them using the differential physical properties intrinsic to cancer and blood cells. We will discuss technologies that isolate cells based on their biomechanical and electrical properties. Label-free approaches to analyze CTCs have been recently invoked as a valid alternative to "marker-based" techniques, because classical epithelial and tumor markers are lost on some CTC populations and there is no comprehensive phenotypic definition for CTCs. We will highlight the advantages and drawbacks of these technologies and the status on their implementation in the clinics.
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Affiliation(s)
- Igor Cima
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos #04-01, Singapore 138669
| | - Chay Wen Yee
- National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
| | | | - Wai Min Phyo
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos #04-01, Singapore 138669
| | - Kiat Hon Lim
- Department of Pathology, Singapore General Hospital, Outram Road, Singapore 169608
| | - Ciprian Iliescu
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos #04-01, Singapore 138669
| | - Min Han Tan
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos #04-01, Singapore 138669 ; National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
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83
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Kralj JG, Arya C, Tona A, Forbes TP, Munson MS, Sorbara L, Srivastava S, Forry SP. A simple packed bed device for antibody labelled rare cell capture from whole blood. LAB ON A CHIP 2012; 12:4972-4975. [PMID: 23079718 DOI: 10.1039/c2lc41048f] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We have developed a system to isolate rare cells from whole blood using commercially available components and simple microfluidics. We characterized the capture of MCF-7 cells spiked into whole human blood using this system to demonstrate that enrichment and enumeration studies give results similar to in situ surface-modified devices while reducing fabrication and operation complexity.
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Affiliation(s)
- Jason G Kralj
- Biochemical Science Division, NIST, 100 Bureau Dr, Gaithersburg, MD, USA
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