151
|
Tsujiura M, Ichikawa D, Konishi H, Komatsu S, Shiozaki A, Otsuji E. Liquid biopsy of gastric cancer patients: Circulating tumor cells and cell-free nucleic acids. World J Gastroenterol 2014; 20:3265-3286. [PMID: 24696609 PMCID: PMC3964398 DOI: 10.3748/wjg.v20.i12.3265] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/27/2013] [Accepted: 02/20/2014] [Indexed: 02/06/2023] Open
Abstract
To improve the clinical outcomes of cancer patients, early detection and accurate monitoring of diseases are necessary. Numerous genetic and epigenetic alterations contribute to oncogenesis and cancer progression, and analyses of these changes have been increasingly utilized for diagnostic, prognostic and therapeutic purposes in malignant diseases including gastric cancer (GC). Surgical and/or biopsy specimens are generally used to understand the tumor-associated alterations; however, those approaches cannot always be performed because of their invasive characteristics and may fail to reflect current tumor dynamics and drug sensitivities, which may change during the therapeutic process. Therefore, the importance of developing a non-invasive biomarker with the ability to monitor real-time tumor dynamics should be emphasized. This concept, so called “liquid biopsy”, would provide an ideal therapeutic strategy for an individual cancer patient and would facilitate the development of “tailor-made” cancer management programs. In the blood of cancer patients, the presence and potent utilities of circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) such as DNA, mRNA and microRNA have been recognized, and their clinical relevance is attracting considerable attention. In this review, we discuss recent developments in this research field as well as the relevance and future perspectives of CTCs and cfNAs in cancer patients, especially focusing on GC.
Collapse
|
152
|
Grover PK, Cummins AG, Price TJ, Roberts-Thomson IC, Hardingham JE. Circulating tumour cells: the evolving concept and the inadequacy of their enrichment by EpCAM-based methodology for basic and clinical cancer research. Ann Oncol 2014; 25:1506-16. [PMID: 24651410 DOI: 10.1093/annonc/mdu018] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence suggests that circulating tumour cells (CTCs) are responsible for metastatic relapse and this has fuelled interest in their detection and quantification. Although numerous methods have been developed for the enrichment and detection of CTCs, none has yet reached the 'gold' standard. Since epithelial cell adhesion molecule (EpCAM)-based enrichment of CTCs offers several advantages, it is one of the most commonly used and has been adapted for high-throughput technology. However, emerging evidence suggests that CTCs are highly heterogeneous: they consist of epithelial tumour cells, epithelial-to-mesenchymal transition (EMT) cells, hybrid (epithelial/EMT(+)) tumour cells, irreversible EMT(+) tumour cells, and circulating tumour stem cells (CTSCs). The EpCAM-based approach does not detect CTCs expressing low levels of EpCAM and non-epithelial phenotypes such as CTSCs and those that have undergone EMT and no longer express EpCAM. Thus, the approach may lead to underestimation of the significance of CTCs, in general, and CTSCs and EMT(+) tumour cells, in particular, in cancer dissemination. Here, we provide a critical review of research literature on the evolving concept of CTCs and the inadequacy of their enrichment by EpCAM-based technology for basic and clinical cancer research. The review also outlines future perspectives in the field.
Collapse
Affiliation(s)
| | | | - T J Price
- Haematology-Oncology, The Queen Elizabeth Hospital, Woodville South, Australia
| | | | - J E Hardingham
- Haematology-Oncology, The Queen Elizabeth Hospital, Woodville South, Australia
| |
Collapse
|
153
|
Faustino V, Pinho D, Yaginuma T, Calhelha RC, Ferreira IC, Lima R. Extensional flow-based microfluidic device: deformability assessment of red blood cells in contact with tumor cells. BIOCHIP JOURNAL 2014. [DOI: 10.1007/s13206-014-8107-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
154
|
Costa C, Abal M, López-López R, Muinelo-Romay L. Biosensors for the detection of circulating tumour cells. SENSORS 2014; 14:4856-75. [PMID: 24618729 PMCID: PMC4003971 DOI: 10.3390/s140304856] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 01/28/2014] [Accepted: 02/28/2014] [Indexed: 12/14/2022]
Abstract
Metastasis is the cause of most cancer deaths. Circulating tumour cells (CTCs) are cells released from the primary tumour into the bloodstream that are considered the main promoters of metastasis. Therefore, these cells are targets for understanding tumour biology and improving clinical management of the disease. Several techniques have emerged in recent years to isolate, detect, and characterise CTCs. As CTCs are a rare event, their study requires multidisciplinary considerations of both biological and physical properties. In addition, as isolation of viable cells may give further insights into metastatic development, cell recovery must be done with minimal cell damage. The ideal system for CTCs analysis must include maximum efficiency of detection in real time. In this sense, new approaches used to enrich CTCs from clinical samples have provided an important improvement in cell recovery. However, this progress should be accompanied by more efficient strategies of cell quantification. A range of biosensor platforms are being introduced into the technology for CTCs quantification with promising results. This review provides an update on recent progress in CTCs identification using different approaches based on sensor signaling.
Collapse
Affiliation(s)
- Clotilde Costa
- Translational Medical Oncology, Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (SERGAS), Trav. Choupana s/n 15706 Santiago de Compostela, Spain.
| | - Miguel Abal
- Translational Medical Oncology, Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (SERGAS), Trav. Choupana s/n 15706 Santiago de Compostela, Spain.
| | - Rafael López-López
- Translational Medical Oncology, Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (SERGAS), Trav. Choupana s/n 15706 Santiago de Compostela, Spain.
| | - Laura Muinelo-Romay
- Unity of CTCs analysis Translational Medical Oncology, Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (SERGAS), Trav. Choupana s/n 15706 Santiago de Compostela, Spain.
| |
Collapse
|
155
|
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.
Collapse
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;
| |
Collapse
|
156
|
Chen P, Huang YY, Hoshino K, Zhang X. Multiscale immunomagnetic enrichment of circulating tumor cells: from tubes to microchips. LAB ON A CHIP 2014; 14:446-58. [PMID: 24292816 DOI: 10.1039/c3lc51107c] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We review the rare cancer cell sorting technologies, with a focus on multiscale immunomagnetic approaches. Starting from the conventional magnetic activated cell sorting system, we derive the scaling laws of immunomagnetic assay and justify the recent trend of using downscaled systems for CTC studies. Furthermore, we introduce recent work on combining the immunomagnetic assay with microfluidic technology for enhanced separation. We summarize different types of in-channel micro-magnetic structures that can further increase the local magnetic field without lowering the system throughput. Related design concepts, principles, and microfabrication techniques are presented and evaluated.
Collapse
Affiliation(s)
- Peng Chen
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA.
| | | | | | | |
Collapse
|
157
|
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.
Collapse
Affiliation(s)
- Kyung-A Hyun
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-no Seodaemun-gu, Seoul 120-752, South Korea.
| | | |
Collapse
|
158
|
Sollier E, Go DE, Che J, Gossett DR, O'Byrne S, Weaver WM, Kummer N, Rettig M, Goldman J, Nickols N, McCloskey S, Kulkarni RP, Di Carlo D. Size-selective collection of circulating tumor cells using Vortex technology. LAB ON A CHIP 2014; 14:63-77. [PMID: 24061411 DOI: 10.1039/c3lc50689d] [Citation(s) in RCA: 351] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A blood-based, low cost alternative to radiation intensive CT and PET imaging is critically needed for cancer prognosis and management of its treatment. "Liquid biopsies" of circulating tumor cells (CTCs) from a relatively non-invasive blood draw are particularly ideal, as they can be repeated regularly to provide up to date molecular information about the cancer, which would also open up key opportunities for personalized therapies. Beyond solely diagnostic applications, CTCs are also a subject of interest for drug development and cancer research. In this paper, we adapt a technology previously introduced, combining the use of micro-scale vortices and inertial focusing, specifically for the high-purity extraction of CTCs from blood samples. First, we systematically varied parameters including channel dimensions and flow rates to arrive at an optimal device for maximum trapping efficiency and purity. Second, we validated the final device for capture of cancer cell lines in blood, considering several factors, including the effect of blood dilution, red blood cell lysis and cell deformability, while demonstrating cell viability and independence on EpCAM expression. Finally, as a proof-of-concept, CTCs were successfully extracted and enumerated from the blood of patients with breast (N = 4, 25-51 CTCs per 7.5 mL) and lung cancer (N = 8, 23-317 CTCs per 7.5 mL). Importantly, samples were highly pure with limited leukocyte contamination (purity 57-94%). This Vortex approach offers significant advantages over existing technologies, especially in terms of processing time (20 min for 7.5 mL of whole blood), sample concentration (collecting cells in a small volume down to 300 μL), applicability to various cancer types, cell integrity and purity. We anticipate that its simplicity will aid widespread adoption by clinicians and biologists who desire to not only enumerate CTCs, but also uncover new CTC biology, such as unique gene mutations, vesicle secretion and roles in metastatic processes.
Collapse
Affiliation(s)
- Elodie Sollier
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, P.O. Box 951600, Los Angeles, CA 90095, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
159
|
Warkiani ME, Guan G, Luan KB, Lee WC, Bhagat AAS, Chaudhuri PK, Tan DSW, Lim WT, Lee SC, Chen PCY, Lim CT, Han J. Slanted spiral microfluidics for the ultra-fast, label-free isolation of circulating tumor cells. LAB ON A CHIP 2014; 14:128-37. [PMID: 23949794 DOI: 10.1039/c3lc50617g] [Citation(s) in RCA: 351] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The enumeration and characterization of circulating tumor cells (CTCs), found in the peripheral blood of cancer patients, provide a potentially accessible source for cancer diagnosis and prognosis. This work reports on a novel spiral microfluidic device with a trapezoidal cross-section for ultra-fast, label-free enrichment of CTCs from clinically relevant blood volumes. The technique utilizes the inherent Dean vortex flows present in curvilinear microchannels under continuous flow, along with inertial lift forces which focus larger CTCs against the inner wall. Using a trapezoidal cross-section as opposed to a traditional rectangular cross-section, the position of the Dean vortex core can be altered to achieve separation. Smaller hematologic components are trapped in the Dean vortices skewed towards the outer channel walls and eventually removed at the outer outlet, while the larger CTCs equilibrate near the inner channel wall and are collected from the inner outlet. By using a single spiral microchannel with one inlet and two outlets, we have successfully isolated and recovered more than 80% of the tested cancer cell line cells (MCF-7, T24 and MDA-MB-231) spiked in 7.5 mL of blood within 8 min with extremely high purity (400-680 WBCs mL(-1); ~4 log depletion of WBCs). Putative CTCs were detected and isolated from 100% of the patient samples (n = 10) with advanced stage metastatic breast and lung cancer using standard biomarkers (CK, CD45 and DAPI) with the frequencies ranging from 3-125 CTCs mL(-1). We expect this simple and elegant approach can surmount the shortcomings of traditional affinity-based CTC isolation techniques as well as enable fundamental studies on CTCs to guide treatment and enhance patient care.
Collapse
Affiliation(s)
- Majid Ebrahimi Warkiani
- BioSystems and Micromechanics (BioSyM) IRG, Singapore-MIT Alliance for Research and Technology (SMART) Centre, Singapore.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
160
|
Earhart CM, Hughes CE, Gaster RS, Ooi CC, Wilson RJ, Zhou LY, Humke EW, Xu L, Wong DJ, Willingham SB, Schwartz EJ, Weissman IL, Jeffrey SS, Neal JW, Rohatgi R, Wakelee HA, Wang SX. Isolation and mutational analysis of circulating tumor cells from lung cancer patients with magnetic sifters and biochips. LAB ON A CHIP 2014; 14:78-88. [PMID: 23969419 PMCID: PMC4144998 DOI: 10.1039/c3lc50580d] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Detection and characterization of circulating tumor cells (CTCs) may reveal insights into the diagnosis and treatment of malignant disease. Technologies for isolating CTCs developed thus far suffer from one or more limitations, such as low throughput, inability to release captured cells, and reliance on expensive instrumentation for enrichment or subsequent characterization. We report a continuing development of a magnetic separation device, the magnetic sifter, which is a miniature microfluidic chip with a dense array of magnetic pores. It offers high efficiency capture of tumor cells, labeled with magnetic nanoparticles, from whole blood with high throughput and efficient release of captured cells. For subsequent characterization of CTCs, an assay, using a protein chip with giant magnetoresistive nanosensors, has been implemented for mutational analysis of CTCs enriched with the magnetic sifter. The use of these magnetic technologies, which are separate devices, may lead the way to routine preparation and characterization of "liquid biopsies" from cancer patients.
Collapse
Affiliation(s)
- Christopher M. Earhart
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Casey E. Hughes
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, 94305, USA
| | - Richard S. Gaster
- Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA
| | - Chin Chun Ooi
- Department of Chemical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Robert J. Wilson
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Lisa Y. Zhou
- Stanford Cancer Institute, Stanford, CA, 94305, USA
| | - Eric W. Humke
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, 94305, USA
| | - Lingyun Xu
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Dawson J. Wong
- Department of Electrical Engineering, Stanford University, California, 94305, USA
| | - Stephen B. Willingham
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford, CA, 94305, USA
| | - Erich J. Schwartz
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Irving L. Weissman
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford, CA, 94305, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | | | - Joel W. Neal
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, 94305, USA
- Stanford Cancer Institute, Stanford, CA, 94305, USA
| | - Rajat Rohatgi
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, 94305, USA
| | - Heather A. Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, 94305, USA
- Stanford Cancer Institute, Stanford, CA, 94305, USA
| | - Shan X. Wang
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA
- Department of Electrical Engineering, Stanford University, California, 94305, USA
- Department of Surgery, Stanford University, Stanford, CA, 94305, USA
- Tel: +1 650-723-8671
| |
Collapse
|
161
|
Adams DL, Zhu P, Makarova OV, Martin SS, Charpentier M, Chumsri S, Li S, Amstutz P, Tang CM. The systematic study of circulating tumor cell isolation using lithographic microfilters. RSC Adv 2014; 9:4334-4342. [PMID: 25614802 DOI: 10.1039/c3ra46839a] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Circulating tumor cells (CTCs) disseminated into peripheral blood from a primary, or metastatic, tumor can be used for early detection, diagnosis and monitoring of solid malignancies. CTC isolation by size exclusion techniques have long interested researchers as a simple broad based approach, which is methodologically diverse for use in both genomic and protein detection platforms. Though a variety of these microfiltration systems are employed academically and commercially, the limited ability to easily alter microfilter designs has hindered the optimization for CTC capture. To overcome this problem, we studied a unique photo-definable material with a scalable and mass producible photolithographic fabrication method. We use this fabrication method to systematically study and optimize the parameters necessary for CTC isolation using a microfiltration approach, followed by a comparison to a "standard" filtration membrane. We demonstrate that properly designed microfilters can capture MCF-7 cancer cells at rate of 98 ± 2% if they consist of uniform patterned distributions, ≥160 000 pores, and 7 μm pore diameters.
Collapse
Affiliation(s)
- Daniel L Adams
- Creatv MicroTech, Inc., 9900 Belward Campus Drive, Suite 330, Rockville, MD 20850, USA
| | - Peixuan Zhu
- Creatv MicroTech, Inc., 9900 Belward Campus Drive, Suite 330, Rockville, MD 20850, USA
| | - Olga V Makarova
- Creatv MicroTech, Inc., 2242 W. Harrison Street, Suite 109B, Chicago, IL 60612-3515, USA
| | - Stuart S Martin
- University of Maryland Baltimore, Greenebaum Cancer Center, 655 W. Baltimore St Suite BRB 10-029, Baltimore, MD 21136, USA
| | - Monica Charpentier
- University of Maryland Baltimore, Greenebaum Cancer Center, 655 W. Baltimore St Suite BRB 10-029, Baltimore, MD 21136, USA
| | - Saranya Chumsri
- University of Maryland Baltimore, Greenebaum Cancer Center, 655 W. Baltimore St Suite BRB 10-029, Baltimore, MD 21136, USA
| | - Shuhong Li
- Creatv MicroTech, Inc., 9900 Belward Campus Drive, Suite 330, Rockville, MD 20850, USA
| | - Platte Amstutz
- Creatv MicroTech, Inc., 11609 Lake Potomac Drive, Potomac, MD 20854, USA
| | - Cha-Mei Tang
- Creatv MicroTech, Inc., 11609 Lake Potomac Drive, Potomac, MD 20854, USA
| |
Collapse
|
162
|
Warkiani ME, Khoo BL, Tan DSW, Bhagat AAS, Lim WT, Yap YS, Lee SC, Soo RA, Han J, Lim CT. An ultra-high-throughput spiral microfluidic biochip for the enrichment of circulating tumor cells. Analyst 2014; 139:3245-55. [DOI: 10.1039/c4an00355a] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We demonstrate the high-throughput and high-resolution separation of rare circulating tumor cells (CTCs) from blood using a multiplexed spiral microfluidic device.
Collapse
Affiliation(s)
- Majid Ebrahimi Warkiani
- BioSystems and Micromechanics (BioSyM) IRG
- Singapore-MIT Alliance for Research and Technology (SMART) Centre
- Singapore
| | - Bee Luan Khoo
- Mechanobiology Institute
- National University of Singapore
- Singapore
- Department of Biomedical Engineering
- National University of Singapore
| | | | | | - Wan-Teck Lim
- Department of Medical Oncology
- National Cancer Centre Singapore
- Singapore
| | - Yoon Sim Yap
- Department of Medical Oncology
- National Cancer Centre Singapore
- Singapore
| | - Soo Chin Lee
- Department of Hematology-Oncology
- National University Hospital
- Singapore
| | - Ross A. Soo
- Department of Hematology-Oncology
- National University Hospital
- Singapore
| | - Jongyoon Han
- BioSystems and Micromechanics (BioSyM) IRG
- Singapore-MIT Alliance for Research and Technology (SMART) Centre
- Singapore
- Department of Electrical Engineering and Computer Science
- Department of Biological Engineering
| | - Chwee Teck Lim
- BioSystems and Micromechanics (BioSyM) IRG
- Singapore-MIT Alliance for Research and Technology (SMART) Centre
- Singapore
- Mechanobiology Institute
- National University of Singapore
| |
Collapse
|
163
|
Abstract
The metastatic dissemination and spread of malignant circulating tumor cells (CTCs) accounts for more than 90% of cancer-related deaths. CTCs detach from a primary tumor, travel through the circulatory system, and then invade and proliferate in distant organs. The detection of CTCs from blood has been established for prognostic monitoring and is predictive of patient outcome. Analysis of CTCs could enable the means for early detection and screening in cancer, as well as provide diagnostic access to tumor tissues in a minimally invasive way. The fundamental challenge with analyzing CTCs is the fact that they occur at extremely low concentrations in blood, on the order of one out of a billion cells. Various technologies have been proposed to isolate CTCs for enrichment. Here we focus on antigen-independent approaches that are not limited by specific capture antibodies. Intrinsic physical properties of CTCs, including cell size, deformability, and electrical properties, are reviewed, and technologies developed to exploit them for enrichment from blood are summarized. Physical enrichment technologies are of particular interest as they have the potential to increase yield and enable the analysis of rare CTC phenotypes that may not be otherwise obtained.
Collapse
Affiliation(s)
- Ramdane A. Harouaka
- Micro & Nano Integrated Biosystem (MINIBio) Laboratory, Department of Bioengineering and Materials Research Institute, Pennsylvania State University, University Park, PA 16802, U.S.A
- Penn State Hershey Cancer Institute, Hershey, PA 17033, U.S.A
| | - Merisa Nisic
- Micro & Nano Integrated Biosystem (MINIBio) Laboratory, Department of Bioengineering and Materials Research Institute, Pennsylvania State University, University Park, PA 16802, U.S.A
- Penn State Hershey Cancer Institute, Hershey, PA 17033, U.S.A
| | - Si-Yang Zheng
- Micro & Nano Integrated Biosystem (MINIBio) Laboratory, Department of Bioengineering and Materials Research Institute, Pennsylvania State University, University Park, PA 16802, U.S.A
- Penn State Hershey Cancer Institute, Hershey, PA 17033, U.S.A
| |
Collapse
|
164
|
Hamon M, Hong JW. New tools and new biology: recent miniaturized systems for molecular and cellular biology. Mol Cells 2013; 36:485-506. [PMID: 24305843 PMCID: PMC3887968 DOI: 10.1007/s10059-013-0333-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 01/09/2023] Open
Abstract
Recent advances in applied physics and chemistry have led to the development of novel microfluidic systems. Microfluidic systems allow minute amounts of reagents to be processed using μm-scale channels and offer several advantages over conventional analytical devices for use in biological sciences: faster, more accurate and more reproducible analytical performance, reduced cell and reagent consumption, portability, and integration of functional components in a single chip. In this review, we introduce how microfluidics has been applied to biological sciences. We first present an overview of the fabrication of microfluidic systems and describe the distinct technologies available for biological research. We then present examples of microsystems used in biological sciences, focusing on applications in molecular and cellular biology.
Collapse
Affiliation(s)
- Morgan Hamon
- Materials Research and Education Center, Department of Mechanical Engineering, Auburn University, Auburn, AL 36849,
USA
| | - Jong Wook Hong
- Materials Research and Education Center, Department of Mechanical Engineering, Auburn University, Auburn, AL 36849,
USA
- College of Pharmacy, Seoul National University, Seoul 151-741,
Korea
- Department of Bionano Engineering, Hanyang University, Ansan 426-791,
Korea
| |
Collapse
|
165
|
Abstract
Cellular separations are required in many contexts in biochemical and biomedical applications for the identification, isolation, and analysis of phenotypes or samples of interest. Microfluidics is uniquely suited for handling biological samples, and emerging technologies have become increasingly accessible tools for researchers and clinicians. Here, we review advances in the last few years in techniques for microfluidic cell separation and manipulation. Applications such as high-throughput cell and organism phenotypic screening, purification of heterogeneous stem cell populations, separation of blood components, and isolation of rare cells in patients highlight some of the areas in which these technologies show great potential. Continued advances in separation mechanisms and understanding of cellular systems will yield further improvements in the throughput, resolution, and robustness of techniques.
Collapse
Affiliation(s)
- Emily L Jackson
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Dr. NW, Atlanta, GA 30332-0100, USA
| | - Hang Lu
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Dr. NW, Atlanta, GA 30332-0100, USA
| |
Collapse
|
166
|
Mitchell MJ, King MR. Physical biology in cancer. 3. The role of cell glycocalyx in vascular transport of circulating tumor cells. Am J Physiol Cell Physiol 2013; 306:C89-97. [PMID: 24133067 PMCID: PMC3919988 DOI: 10.1152/ajpcell.00285.2013] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Circulating tumor cells (CTCs) in blood are known to adhere to the luminal surface of the microvasculature via receptor-mediated adhesion, which contributes to the spread of cancer metastasis to anatomically distant organs. Such interactions between ligands on CTCs and endothelial cell-bound surface receptors are sensitive to receptor-ligand distances at the nanoscale. The sugar-rich coating expressed on the surface of CTCs and endothelial cells, known as the glycocalyx, serves as a physical structure that can control the spacing and, thus, the availability of such receptor-ligand interactions. The cancer cell glycocalyx can also regulate the ability of therapeutic ligands to bind to CTCs in the bloodstream. Here, we review the role of cell glycocalyx on the adhesion and therapeutic treatment of CTCs in the bloodstream.
Collapse
Affiliation(s)
- Michael J Mitchell
- Department of Biomedical Engineering, Cornell University, Ithaca, New York
| | | |
Collapse
|
167
|
Harouaka R, Kang Z, Zheng SY, Cao L. Circulating tumor cells: advances in isolation and analysis, and challenges for clinical applications. Pharmacol Ther 2013; 141:209-21. [PMID: 24134902 DOI: 10.1016/j.pharmthera.2013.10.004] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 12/28/2022]
Abstract
Circulating tumor cells (CTCs) are rare cancer cells released from tumors into the bloodstream that are thought to have a key role in cancer metastasis. The presence of CTCs has been associated with worse prognosis in several major cancer types, including breast, prostate and colorectal cancer. There is considerable interest in CTC research and technologies for their potential use as cancer biomarkers that may enhance cancer diagnosis and prognosis, facilitate drug development, and improve the treatment of cancer patients. This review provides an update on recent progress in CTC isolation and molecular characterization technologies. Furthermore, the review covers significant advances and limitations in the clinical applications of CTC-based assays for cancer prognosis, response to anti-cancer therapies, and exploratory studies in biomarkers predictive of sensitivity and resistance to cancer therapies.
Collapse
Affiliation(s)
- Ramdane Harouaka
- Department of Bioengineering, Penn State University, University Park, PA, USA
| | - Zhigang Kang
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Si-Yang Zheng
- Department of Bioengineering, Penn State University, University Park, PA, USA
| | - Liang Cao
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
| |
Collapse
|
168
|
Abstract
With the experimental tools and knowledge that have accrued from a long history of reductionist biology, we can now start to put the pieces together and begin to understand how biological systems function as an integrated whole. Here, we describe how microfabricated tools have demonstrated promise in addressing experimental challenges in throughput, resolution, and sensitivity to support systems-based approaches to biological understanding.
Collapse
Affiliation(s)
- Mei Zhan
- Interdisciplinary Program in Bioengineering, Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Loice Chingozha
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Hang Lu
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States
| |
Collapse
|
169
|
Kamande J, Hupert M, Witek M, Wang H, Torphy R, Dharmasiri U, Njoroge S, Jackson J, Aufforth R, Snavely A, Yeh J, Soper S. Modular microsystem for the isolation, enumeration, and phenotyping of circulating tumor cells in patients with pancreatic cancer. Anal Chem 2013; 85:9092-100. [PMID: 23947293 PMCID: PMC3832346 DOI: 10.1021/ac401720k] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this manuscript, we discuss the development and clinical use of a thermoplastic modular microsystem for the high-throughput analysis of CTCs directly from whole blood. The modular system offers some innovative features that address challenges currently associated with many CTC platforms; it can exhaustively process 7.5 mL of blood in less than 45 min with recoveries >90%. In addition, the system automates the postselection CTC processing steps and thus, significantly reduces assay turnaround time (from selection to enumeration <1.5 h as compared to >8 h for many reported CTC platforms). The system is composed of 3 functional modules including (i) a thermoplastic CTC selection module composed of high aspect ratio (30 μm × 150 μm) channels containing anti-EpCAM antibodies that is scalable in terms of throughput by employing channel numbers ranging from 50 to 320; the channel number is user selected to accommodate the volume of blood that must be processed; (ii) an impedance sensor module for label-less CTC counting; and (iii) a staining and imaging module for the placement of released cells into a 2D array within a common imaging plane for phenotypic identification. To demonstrate the utility of this system, blood samples from patients with local resectable and metastatic pancreatic ductal adenocarcinoma (PDAC) were analyzed. We demonstrate the ability to select EpCAM positive CTCs from PDAC patients in high purity (>86%) and with excellent yields (mean = 53 CTCs per mL for metastatic PDAC patients) using our modular system. In addition, we demonstrate the ability to detect CTCs in PDAC patients with local resectable disease (mean = 11 CTCs per mL).
Collapse
Affiliation(s)
- J.W. Kamande
- Department of Chemistry, Louisiana State University, 232 Choppin Hall, Baton Rouge, LA 70803-1804, USA
| | - M.L. Hupert
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - M.A. Witek
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - H. Wang
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
| | - R.J. Torphy
- University of North Carolina, School of Medicine Chapel Hill, 321 S Columbia St, Chapel Hill, NC 27514, USA
| | - U. Dharmasiri
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
| | - S.K. Njoroge
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
| | - J.M. Jackson
- Department of Chemistry, University of North Carolina, Campus Box 3290, Chapel Hill, NC 27599-3290, USA
| | - R.D. Aufforth
- Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of North Carolina School of Medicine, 170 Manning Dr., Chapel Hill, NC
| | - A. Snavely
- UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, USA
| | - J.J. Yeh
- University of North Carolina, School of Medicine Chapel Hill, 321 S Columbia St, Chapel Hill, NC 27514, USA
- Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of North Carolina School of Medicine, 170 Manning Dr., Chapel Hill, NC
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC
- UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, USA
| | - S.A. Soper
- BioFluidica, LLC, c/o Carolina Kick-Start, 321 Bondurant Hall, Chapel Hill, NC, 27599
- Department of Biomedical Engineering, University of North Carolina, 152 MacNider Hall Campus Box 7575 Chapel Hill, NC 27599-7575, USA
- Department of Chemistry, University of North Carolina, Campus Box 3290, Chapel Hill, NC 27599-3290, USA
- Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| |
Collapse
|
170
|
Sun W, Jia C, Huang T, Sheng W, Li G, Zhang H, Jing F, Jin Q, Zhao J, Li G, Zhang Z. High-performance size-based microdevice for the detection of circulating tumor cells from peripheral blood in rectal cancer patients. PLoS One 2013; 8:e75865. [PMID: 24066187 PMCID: PMC3774665 DOI: 10.1371/journal.pone.0075865] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/16/2013] [Indexed: 01/03/2023] Open
Abstract
Since individualized therapy becomes more and more important in the treatment of rectal cancer, an accurate and effective approach should be established in the clinical settings to help physicians to make their decisions. Circulating tumor cells (CTCs), originated from either primary or metastatic cancer, could provide important information for diagnosis and monitoring of cancer. However, the implication and development of CTCs are limited due to the extreme rarity of these tumor cells. In this study we fabricated a simple and high-performance microfluidic device, which exploited numerous filtered microchannels in it to enrich the large-sized target tumor cells from whole blood. A very high CTC capture efficiency (average recovery rate: 94%) was obtained in this device at the optimum flow rate of 0.5 mL/h and channel height of 5 µm. Additionally, we used this device for detecting CTCs in 60 patients with rectal cancer. The CTC counts of rectal cancer patients were significantly higher than those in healthy subjects. Furthermore, the CTC counts detected by this device were significantly higher than those by EpCAM bead-based method for rectal cancer patients with various stage. Especially, for localized rectal cancer patients, the positive rates of samples with more than 3 CTCs per 5 mL blood by use of microdevice vs. EpCAM-based ones were 100% vs. 47%, respectively. Thus, this device provides a new and effective tool for accurate identification and measurement of CTCs in patients with rectal cancer, and has broad potential in clinical practice.
Collapse
Affiliation(s)
- Wenjie Sun
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chunping Jia
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Ting Huang
- Department of tumor chemotherapy, the Affiliated Hospital of Nantong University, Jiangsu, China
| | - Weiqi Sheng
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Guichao Li
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Honglian Zhang
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Fengxiang Jing
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Qinghui Jin
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Jianlong Zhao
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Gang Li
- Key Laboratories of Transducer Technology and Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
- * E-mail: (ZZ); (GL)
| | - Zhen Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- * E-mail: (ZZ); (GL)
| |
Collapse
|
171
|
Wang H, Chen NG, Minev BR, Zimmermann M, Aguilar RJ, Zhang Q, Sturm JB, Fend F, Yu YA, Cappello J, Lauer UM, Szalay AA. Optical detection and virotherapy of live metastatic tumor cells in body fluids with vaccinia strains. PLoS One 2013; 8:e71105. [PMID: 24019862 PMCID: PMC3760980 DOI: 10.1371/journal.pone.0071105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 06/25/2013] [Indexed: 02/06/2023] Open
Abstract
Metastatic tumor cells in body fluids are important targets for treatment, and critical surrogate markers for evaluating cancer prognosis and therapeutic response. Here we report, for the first time, that live metastatic tumor cells in blood samples from mice bearing human tumor xenografts and in blood and cerebrospinal fluid samples from patients with cancer were successfully detected using a tumor cell-specific recombinant vaccinia virus (VACV). In contrast to the FDA-approved CellSearch system, VACV detects circulating tumor cells (CTCs) in a cancer biomarker-independent manner, thus, free of any bias related to the use of antibodies, and can be potentially a universal system for detection of live CTCs of any tumor type, not limited to CTCs of epithelial origin. Furthermore, we demonstrate for the first time that VACV was effective in preventing and reducing circulating tumor cells in mice bearing human tumor xenografts. Importantly, a single intra-peritoneal delivery of VACV resulted in a dramatic decline in the number of tumor cells in the ascitic fluid from a patient with gastric cancer. Taken together, these results suggest VACV to be a useful tool for quantitative detection of live tumor cells in liquid biopsies as well as a potentially effective treatment for reducing or eliminating live tumor cells in body fluids of patients with metastatic disease.
Collapse
Affiliation(s)
- Huiqiang Wang
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
| | - Nanhai G. Chen
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
- Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, United States of America
| | - Boris R. Minev
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
- Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, United States of America
- UCSD Division of Neurosurgery, University of California, San Diego, California, United States of America
| | - Martina Zimmermann
- Department of Gastroenterology and Hepatology, University Hospital, Tuebingen, Germany
| | - Richard J. Aguilar
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
| | - Qian Zhang
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
- Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, United States of America
| | - Julia B. Sturm
- Department of Gastroenterology and Hepatology, University Hospital, Tuebingen, Germany
| | - Falko Fend
- Institute of Pathology, University Hospital, Tuebingen, Germany
| | - Yong A. Yu
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
- Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, United States of America
| | - Joseph Cappello
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
| | - Ulrich M. Lauer
- Department of Gastroenterology and Hepatology, University Hospital, Tuebingen, Germany
| | - Aladar A. Szalay
- Genelux Corporation, San Diego Science Center, San Diego, California, United States of America
- Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, United States of America
- Department of Biochemistry, Rudolf Virchow Center for Experimental Biomedicine, and Institute for Molecular Infection Biology, University of Wuerzburg, Wuerzburg, Germany
- * E-mail:
| |
Collapse
|
172
|
Esmaeilsabzali H, Beischlag TV, Cox ME, Parameswaran AM, Park EJ. Detection and isolation of circulating tumor cells: principles and methods. Biotechnol Adv 2013; 31:1063-84. [PMID: 23999357 DOI: 10.1016/j.biotechadv.2013.08.016] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/24/2013] [Accepted: 08/19/2013] [Indexed: 12/17/2022]
Abstract
Efforts to improve the clinical management of several cancers include finding better methods for the quantitative and qualitative analysis of circulating tumor cells (CTCs). However, detection and isolation of CTCs from the blood circulation is not a trivial task given their scarcity and the lack of reliable markers to identify these cells. With a variety of emerging technologies, a thorough review of the exploited principles and techniques as well as the trends observed in the development of these technologies can assist researchers to recognize the potential improvements and alternative approaches. To help better understand the related biological concepts, a simplified framework explaining cancer formation and its spread to other organs as well as how CTCs contribute to this process has been presented first. Then, based on their basic working-principles, the existing methods for detection and isolation of CTCs have been classified and reviewed as nucleic acid-based, physical properties-based and antibody-based methods. The review of literature suggests that antibody-based methods, particularly in conjunction with a microfluidic lab-on-a-chip setting, offer the highest overall performance for detection and isolation of CTCs. Further biological and engineering-related research is required to improve the existing methods. These include finding more specific markers for CTCs as well as enhancing the throughput, sensitivity, and analytic functionality of current devices.
Collapse
Affiliation(s)
- Hadi Esmaeilsabzali
- School of Mechatronic Systems Engineering, Simon Fraser University, 250-13450 102nd Avenue, Surrey, V3T 0A3, BC, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, BC, Canada; School of Engineering Science, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, BC, Canada
| | | | | | | | | |
Collapse
|
173
|
Matthew EM, Gallant JN. Sizing up circulating tumor cells for personalized therapy. Cell Cycle 2013; 12:2346. [PMID: 23887387 PMCID: PMC3841311 DOI: 10.4161/cc.25776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
174
|
Zhang ZY, Ge HY. Micrometastasis in gastric cancer. Cancer Lett 2013; 336:34-45. [DOI: 10.1016/j.canlet.2013.04.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 12/19/2022]
|
175
|
Huang T, Jia CP, Jun-Yang, Sun WJ, Wang WT, Zhang HL, Cong H, Jing FX, Mao HJ, Jin QH, Zhang Z, Chen YJ, Li G, Mao GX, Zhao JL. Highly sensitive enumeration of circulating tumor cells in lung cancer patients using a size-based filtration microfluidic chip. Biosens Bioelectron 2013; 51:213-8. [PMID: 23962709 DOI: 10.1016/j.bios.2013.07.044] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/13/2013] [Accepted: 07/22/2013] [Indexed: 12/21/2022]
Abstract
Circulating tumor cells (CTCs) in the peripheral blood could serve as a surrogate marker for the diagnosis of cancer metastasis and for therapeutic evaluation. However, the separation and characterization of CTCs is technically challenging owing to the extremely low number of CTCs present. Here we developed a size-based and high-throughput microfluidic chip, which exploits filtration microchannels to isolate the relatively larger CTCs from the rest of the blood constituents. High isolation efficiency of our microfluidic chip was demonstrated with three lung cancer cell lines spiked in blood samples at an optimal flow rate of 0.4 mL/h. The average recovery rates of 96%, 95% and 92% were obtained for A549, SK-MES-1, and H446, respectively. To clinically validate the chip, we also employed it to isolate CTCs from 59 lung cancer patients. CTCs were detected in 96.7% of patients with the mean number of 18.6 cells/mL, which was significantly higher than normal controls (P<0.05). The work here indicates that the size-based microfluidic platform with the advantage of capturing tumor cells without reliance on cell surface expression markers can provide a novel, inexpensive and effective tool for CTC detection and evaluation of cancer status.
Collapse
Affiliation(s)
- Ting Huang
- State Key Laboratory of Transducer Technology and the Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, 865 Changning Road, Shanghai 200050, China; Department of Tumor Chemotherapy, The Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, Jiangsu 226001, China; Department of Oncology, The People's Hospital of Chizhou, No. 3 Baiya Middle Road, Chizhou, Anhui 247100, China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
176
|
Tang L, Zhao S, Liu W, Parchim NF, Huang J, Tang Y, Gan P, Zhong M. Diagnostic accuracy of circulating tumor cells detection in gastric cancer: systematic review and meta-analysis. BMC Cancer 2013; 13:314. [PMID: 23806209 PMCID: PMC3699416 DOI: 10.1186/1471-2407-13-314] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 06/20/2013] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Circulating tumor cells (CTCs) detection has previously been used for diagnosing gastric cancer. However, the previous studies failed to make an agreement whether the detection of CTCs contributes to the diagnosis of gastric cancer. METHODS A systematic review and meta-analysis was performed to evaluate the overall accuracy of CTCs detection for diagnosing gastric cancer. PubMed, Embase and the Wanfang database were searched in all languages published up to Oct 2012. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR) and summary receiver operating characteristic (sROC) curve were calculated to evaluate the overall test performance. RESULTS Twenty studies were included in this systematic review and meta-analysis. The diagnostic value of CTCs detection for the gastric cancer was calculated to evaluate the overall test performance. The summary estimates of The pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio were 0.42 (95% confidence interval (CI), 0.21-0.67), 0.99 (95% CI, 0.96-1.00), 58.2 (95% CI, 9.8-345.9), 0.58 (95% CI, 0.38-0.89), and 100 (95% CI, 15-663), respectively. The summary receiver operating characteristic curve was 0.97 (95% CI, 0.95-0.98). Deek's funnel plot asymmetry test found no evidence of study publication bias in the current study (P = 0.49). CONCLUSION This systematic review suggests that CTCs detection alone cannot be recommended as a screening test for gastric cancer. However, it might be used as a noninvasive method for the confirmation of the gastric cancer diagnosis.
Collapse
Affiliation(s)
- Lanhua Tang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | | | | | | | | | | | | | | |
Collapse
|
177
|
Lin BK, McFaul SM, Jin C, Black PC, Ma H. Highly selective biomechanical separation of cancer cells from leukocytes using microfluidic ratchets and hydrodynamic concentrator. BIOMICROFLUIDICS 2013; 7:34114. [PMID: 24404034 PMCID: PMC3710247 DOI: 10.1063/1.4812688] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/18/2013] [Indexed: 05/11/2023]
Abstract
The separation of cells based on their biomechanical properties, such as size and deformability, is important in applications such as the identification of circulating tumor cells, where morphological differences can be used to distinguish target cancer cells from contaminant leukocytes. Existing filtration-based separation processes are limited in their selectivity and their ability to extract the separated cells because of clogging in the filter microstructures. We present a cell separation device consisting of a hydrodynamic concentrator and a microfluidic ratchet mechanism operating in tandem. The hydrodynamic concentrator removes the majority of the fluid and a fraction of leukocytes based on size, while the microfluidic ratchet mechanism separates cancer cells from leukocytes based on a combination of size and deformability. The irreversible ratcheting process enables highly selective separation and robust extraction of separated cells. Using cancer cells spiked into leukocyte suspensions, the complete system demonstrated a yield of 97%, while enriching the concentration of target cancer cells 3000 fold relative to the concentration of leukocytes.
Collapse
Affiliation(s)
- Bill K Lin
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, British Columbia, Canada V6T 1Z4
| | - Sarah M McFaul
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, British Columbia, Canada V6T 1Z4
| | - Chao Jin
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, British Columbia, Canada V6T 1Z4
| | - Peter C Black
- Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, British Columbia, Canada V5Z 1M9 ; Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - Hongshen Ma
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, British Columbia, Canada V6T 1Z4 ; Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, British Columbia, Canada V5Z 1M9 ; Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| |
Collapse
|
178
|
Lee MG, Shin JH, Bae CY, Choi S, Park JK. Label-Free Cancer Cell Separation from Human Whole Blood Using Inertial Microfluidics at Low Shear Stress. Anal Chem 2013; 85:6213-8. [DOI: 10.1021/ac4006149] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Myung Gwon Lee
- Department of Bio
and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu,
Daejeon 305-701, Republic of Korea
| | - Joong Ho Shin
- Department of Bio
and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu,
Daejeon 305-701, Republic of Korea
| | - Chae Yun Bae
- Department of Bio
and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu,
Daejeon 305-701, Republic of Korea
| | - Sungyoung Choi
- Department of Biomedical
Engineering, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701,
Republic of Korea
| | - Je-Kyun Park
- Department of Bio
and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu,
Daejeon 305-701, Republic of Korea
- KAIST Institute for the NanoCentury, 291 Daehak-ro, Yuseong-gu, Daejeon
305-701, Republic of Korea
| |
Collapse
|
179
|
Gallant JN, Matthew EM, Cheng H, Harouaka R, Lamparella NE, Kunkel M, Yang Z, Harvey HA, Cream LV, Kumar SM, Robertson GP, Zheng S, Drabick JJ, Truica CI, El-Deiry WS. Predicting therapy response in live tumor cells isolated with the flexible micro spring array device. Cell Cycle 2013; 12:2132-43. [PMID: 23759587 PMCID: PMC3737315 DOI: 10.4161/cc.25165] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cells disseminated from primary epithelial tumors into peripheral blood, called circulating tumor cells (CTCs), can be monitored to assess metastases and to provide a surrogate marker of treatment response. Here, we demonstrate how the flexible micro spring array (FMSA) device—a novel microfluidic device that enriches CTCs by two physical parameters: size and deformability—could be used in the rational development of treatment intervention and as a method to study the fundamental biology of CTCs. Cancer cells of different origins were spiked into healthy samples of donor blood to mimic blood samples of metastatic cancer patients. This spiked human blood was filtered using the FMSA device, and the recovered cells were successfully expanded in vitro and in a novel in vivo system. A series of experiments were performed to characterize these cells and to investigate the effect of chemotherapy on the resulting cultures. As few as 20 colon cancer cells in 7.5 mL blood could be isolated with the FMSA device, expanded both in vitro and in vivo and used at 25 cells per well to obtain significant and reliable chemosensitivity data. We also show that isolating a low number of viable patient CTCs and maintaining them in culture for a few weeks is possible. The isolation of viable cancer cells from human blood using the FMSA device provides a novel and realistic means for studying the biology of viable CTCs and for testing drug efficacy on these rare cells—a hypothesis that can be tested in future clinical trials.
Collapse
Affiliation(s)
- Jean-Nicolas Gallant
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Division of Hematology-Oncology, Penn State Hershey Cancer Institute; Hershey, PA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
180
|
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.
Collapse
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.
| | | | | |
Collapse
|
181
|
Lv P, Tang Z, Liang X, Guo M, Han RPS. Spatially gradated segregation and recovery of circulating tumor cells from peripheral blood of cancer patients. BIOMICROFLUIDICS 2013; 7:34109. [PMID: 24404029 PMCID: PMC3689820 DOI: 10.1063/1.4808456] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/21/2013] [Indexed: 05/11/2023]
Abstract
For cancer patients, the enumeration of rare circulating tumor cells (CTCs) in peripheral blood is a strong prognostic indicator of the severity of the cancer; for the general population, the capture of CTCs is needed for use as a clinical tool for cancer screening, early detection, and treatment assessment. Here, we present a fast, high-purity (∼90%) and high-efficiency (>90%) method for the segregation and undamaged recovery of CTCs using a spatially gradated microfluidic chip. Further, by lysing the red blood cells we achieved not only a significant reduction in the overall processing time but also mitigated the blood clogging problem commonly encountered in microfluidic-based CTC isolation systems. To clinically validate the chip, we employed it to detect and capture CTCs from 10 liver cancer patients. Positive CTC enumeration was observed in all the blood samples, and the readings ranged from a low of 1-2 CTCs (1 patient) to a high of >20 CTCs (2 patients) with the balance having 3-20 CTCs per 3-ml blood sample. The work here indicates that our system can be developed for use in cancer screening, metastatic assessment, and chemotherapeutic response and for pharmacological and genetic evaluation of single CTCs.
Collapse
Affiliation(s)
- Peitao Lv
- Department of Materials Science and Engineering, Peking University, Beijing 100871, China
| | - Zhewen Tang
- Department of Materials Science and Engineering, Peking University, Beijing 100871, China
| | - Xingjie Liang
- Laboratory for Nanobiomedicine and Nanosafety, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Mingzhou Guo
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Ray P S Han
- Department of Materials Science and Engineering, Peking University, Beijing 100871, China
| |
Collapse
|
182
|
Ang JE, Kaye S, Banerji U. Tissue-based approaches to study pharmacodynamic endpoints in early phase oncology clinical trials. Curr Drug Targets 2013; 13:1525-34. [PMID: 22974395 PMCID: PMC3531821 DOI: 10.2174/138945012803530062] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 01/12/2010] [Accepted: 09/07/2012] [Indexed: 01/10/2023]
Abstract
Anti-cancer clinical drug development is currently costly and slow with a high attrition rate. There is thus an urgent and unmet need to integrate pharmacodynamic biomarkers into early phase clinical trials in the framework provided by the “pharmacologic audit trail” in order to overcome this challenge. This review discusses the rationale, advantages and disadvantages, as well as the practical considerations of various tissue-based approaches to perform pharmacodynamic studies in early phase oncology clinical trials using case histories of molecular targeting agents such as PI3K, m-TOR, HSP90, HDAC and PARP inhibitors. These approaches include the use of normal “surrogate” tissues such as peripheral blood mononuclear cells, platelet-rich plasma, plucked hair follicles, skin biopsies, plasma-based endocrine assays, proteomics, metabolomics and circulating endothelial cells. In addition, the review discusses the use of neoplastic tissues including tumor biopsies, circulating tumor DNA and tumor cells and metabolomic approaches. The utilization of these tissues and technology platforms to study biomarkers will help accelerate the development of molecularly targeted agents for the treatment of cancer.
Collapse
Affiliation(s)
- Joo Ern Ang
- The Institute of Cancer Research, Sutton, UK
| | | | | |
Collapse
|
183
|
Lim E, Tay A, Nicholson AG. Antibody independent microfluidic cell capture of circulating tumor cells for the diagnosis of cancer. J Thorac Oncol 2013; 7:e42-e43. [PMID: 23154567 DOI: 10.1097/jto.0b013e3182748d5b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Eric Lim
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom.
| | - Andee Tay
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - Andrew G Nicholson
- Department of Histopathology, National Heart and Lung Division, Imperial College, London, United Kingdom
| |
Collapse
|
184
|
Coumans FAW, van Dalum G, Beck M, Terstappen LWMM. Filtration parameters influencing circulating tumor cell enrichment from whole blood. PLoS One 2013; 8:e61774. [PMID: 23658615 PMCID: PMC3637225 DOI: 10.1371/journal.pone.0061774] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 03/12/2013] [Indexed: 12/23/2022] Open
Abstract
Filtration can achieve circulating tumor cell (CTC) enrichment from blood. Key parameters such as flow-rate, applied pressure, and fixation, vary largely between assays and their influence is not well understood. Here, we used a filtration system, to monitor these parameters and determine their relationships. Whole blood, or its components, with and without spiked tumor cells were filtered through track-etched filters. We characterize cells passing through filter pores by their apparent viscosity; the viscosity of a fluid that would pass with the same flow. We measured a ratio of 5·10(4)∶10(2)∶1 for the apparent viscosities of 15 µm diameter MDA-231 cells, 10 µm white cells and 90 fl red cells passing through a 5 µm pore. Fixation increases the pressure needed to pass cells through 8 µm pores 25-fold and halves the recovery of spiked tumor cells. Filtration should be performed on unfixed samples at a pressure of ∼10 mbar for a 1 cm(2) track-etched filter with 5 µm pores. At this pressure MDA-231 cells move through the filter in 1 hour. If fixation is needed for sample preservation, a gentle fixative should be selected. The difference in apparent viscosity between CTC and blood cells is key in optimizing recovery of CTC.
Collapse
Affiliation(s)
- Frank A. W. Coumans
- Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, The Netherlands
| | - Guus van Dalum
- Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, The Netherlands
| | - Markus Beck
- Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, The Netherlands
| | | |
Collapse
|
185
|
Shen Q, Xu L, Zhao L, Wu D, Fan Y, Zhou Y, OuYang WH, Xu X, Zhang Z, Song M, Lee T, Garcia MA, Xiong B, Hou S, Tseng HR, Fang X. Specific capture and release of circulating tumor cells using aptamer-modified nanosubstrates. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2013; 25:2368-73. [PMID: 23495071 PMCID: PMC3786685 DOI: 10.1002/adma.201300082] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Indexed: 05/19/2023]
Affiliation(s)
- Qinglin Shen
- Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071 (P. R. China); Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Li Xu
- Key Laboratory of Molecular Nanostructure and Nanotechnology, Institute of Chemistry, Chinese Academy of Science, Beiyi Street 2#, Zhongguancun, Beijing, 100190 (P.R. China)
| | - Libo Zhao
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com Key Laboratory of Molecular Nanostructure and Nanotechnology, Institute of Chemistry, Chinese Academy of Science, Beiyi Street 2#, Zhongguancun, Beijing, 100190 (P.R. China)
| | - Dongxia Wu
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Yunshan Fan
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Yiliang Zhou
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Wei-Han OuYang
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Xiaochun Xu
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Zhen Zhang
- Key Laboratory of Molecular Nanostructure and Nanotechnology, Institute of Chemistry, Chinese Academy of Science, Beiyi Street 2#, Zhongguancun, Beijing, 100190 (P.R. China)
| | - Min Song
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Tom Lee
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Mitch A. Garcia
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Bin Xiong
- Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071 (P. R. China)
| | - Shuang Hou
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Hsian-Rong Tseng
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095-1770 (USA), Web: http://tseng-lab.com
| | - Xiaohong Fang
- Key Laboratory of Molecular Nanostructure and Nanotechnology, Institute of Chemistry, Chinese Academy of Science, Beiyi Street 2#, Zhongguancun, Beijing, 100190 (P.R. China)
| |
Collapse
|
186
|
Hong B, Zu Y. Detecting circulating tumor cells: current challenges and new trends. Theranostics 2013; 3:377-94. [PMID: 23781285 PMCID: PMC3677409 DOI: 10.7150/thno.5195] [Citation(s) in RCA: 248] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 11/01/2012] [Indexed: 12/16/2022] Open
Abstract
Circulating tumor cells (CTCs) in the blood stream play a critical role in establishing metastases. The clinical value of CTCs as a biomarker for early cancer detection, diagnosis, prognosis, prediction, stratification, and pharmacodynamics have been widely explored in recent years. However, the clinical utility of current CTC tests is limited mainly due to methodological constraints. In this review, the pros and cons of the reported CTC assays are comprehensively discussed. In addition, the potential of tumor cell-derived materials as new targets for CTC detection, including circulating tumor microemboli, cell fragments, and circulating DNA, is evaluated. Finally, emerging approaches for CTC detection, including telomerase-based or aptamer-based assays and cell functional analysis, are also assessed. Expectantly, a thorough review of the current knowledge and technology of CTC detection will assist the scientific community in the development of more efficient CTC assay systems.
Collapse
Affiliation(s)
- Bin Hong
- 1. TeloVISION, LLC, 1281 Win Hentschel Blvd. West Lafayette, IN 47906, USA
| | - Youli Zu
- 2. Department of Pathology and Genomic Medicine, The Methodist Hospital, 6565 Fannin, MS205, Houston, TX 77030, USA
| |
Collapse
|
187
|
Warkiani ME, Bhagat AAS, Khoo BL, Han J, Lim CT, Gong HQ, Fane AG. Isoporous micro/nanoengineered membranes. ACS NANO 2013; 7:1882-1904. [PMID: 23442009 DOI: 10.1021/nn305616k] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Isoporous membranes are versatile structures with numerous potential and realized applications in various fields of science such as micro/nanofiltration, cell separation and harvesting, controlled drug delivery, optics, gas separation, and chromatography. Recent advances in micro/nanofabrication techniques and material synthesis provide novel methods toward controlling the detailed microstructure of membrane materials, allowing fabrication of membranes with well-defined pore size and shape. This review summarizes the current state-of-the-art for isoporous membrane fabrication using different techniques, including microfabrication, anodization, and advanced material synthesis. Various applications of isoporous membranes, such as protein filtration, pathogen isolation, cell harvesting, biosensing, and drug delivery, are also presented.
Collapse
Affiliation(s)
- Majid Ebrahimi Warkiani
- BioSystems and Micromechanics (BioSyM) IRG, Singapore-MIT Alliance for Research and Technology (SMART) Centre, Singapore.
| | | | | | | | | | | | | |
Collapse
|
188
|
Hou S, Zhao L, Shen Q, Yu J, Ng C, Kong X, Wu D, Song M, Shi X, Xu X, OuYang WH, He R, Zhao XZ, Lee T, Brunicardi FC, Garcia MA, Ribas A, Lo RS, Tseng HR. Polymer nanofiber-embedded microchips for detection, isolation, and molecular analysis of single circulating melanoma cells. Angew Chem Int Ed Engl 2013; 52:3379-83. [PMID: 23436302 PMCID: PMC3807678 DOI: 10.1002/anie.201208452] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 12/20/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Shuang Hou
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA, Web: http://www.tseng-lab.com
| | - Libo Zhao
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| | - Qinglin Shen
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
- Department of Applied Physics and Department of Oncology Surgery,
Wuhan University, Wuhan, PRC
| | - Juehua Yu
- Department of Surgery, University of California, Los Angeles
| | - Charles Ng
- Division of Hematology and Oncology, Department of Medicine,
Department of Surgery, and Department of Molecular and Medical Pharmacology,
University of California, Los Angeles
| | - Xiangju Kong
- Division of Dermatology, Department of Medicine, University of
California, Los Angeles
| | - Dongxia Wu
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| | - Min Song
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| | - Xiaohong Shi
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| | - Xiaochun Xu
- CytoLumina Technologies Corp., 21038 Commerce Point Dr., Walnut,
CA 91789, USA
| | - Wei-Han OuYang
- CytoLumina Technologies Corp., 21038 Commerce Point Dr., Walnut,
CA 91789, USA
| | - Rongxian He
- Department of Applied Physics and Department of Oncology Surgery,
Wuhan University, Wuhan, PRC
| | - Xing-Zhong Zhao
- Department of Applied Physics and Department of Oncology Surgery,
Wuhan University, Wuhan, PRC
| | - Tom Lee
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| | | | - Mitch André Garcia
- CytoLumina Technologies Corp., 21038 Commerce Point Dr., Walnut,
CA 91789, USA
| | - Antoni Ribas
- Division of Hematology and Oncology, Department of Medicine,
Department of Surgery, and Department of Molecular and Medical Pharmacology,
University of California, Los Angeles
| | - Roger S. Lo
- Division of Dermatology, Department of Medicine, University of
California, Los Angeles
| | - Hsian-Rong Tseng
- Department of Molecular and Medical Pharmacology, Crump Institute
for Molecular Imaging (CIMI), California NanoSystems Institute (CNSI),
University of California, Los Angeles, 570 Westwood Plaza, Building 114, Los
Angeles, CA 90095-1770, USA
| |
Collapse
|
189
|
Abstract
A recent paper reports that circulating tumor cells (CTCs) from metastatic breast cancer patients exhibit heterogeneous epithelial and mesenchymal phenotypes and that CTCs display higher frequencies of partial or full-blown mesenchymal phenotype than carcinoma cells within primary tumors. Mesenchymal-like CTCs are also elevated in patients who are refractory to therapy.
Collapse
Affiliation(s)
- Jean Paul Thiery
- Department of Biochemistry, National University of Singapore, Singapore 117599.
| | | |
Collapse
|
190
|
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.
Collapse
Affiliation(s)
- Hyoungseon Choi
- Interdisciplinary Program, Bioengineering Major, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
191
|
Abstract
To improve future drug development and patient management for patients with castration-resistant prostate cancer (CRPC), surrogate biomarkers that are linked to relevant outcomes are urgently needed. A biomarker must be measurable, reproducible, linked to relevant clinical outcomes, and demonstrate clinical utility. This area is rapidly evolving, with recent trials in patients with CRPC incorporating the detection of circulating tumour cells (CTCs), imaging, and patient-reported outcome biomarkers. We discuss the framework for the development of biomarkers for CRPC, including different categories and contexts of use. We also highlight the requirements of analytical validation, the sequence of trials needed for clinical validation and regulatory approval, and the future outlook for imaging and CTC biomarkers.
Collapse
|
192
|
Microfluidics and Circulating Tumor Cells. J Mol Diagn 2013; 15:149-57. [DOI: 10.1016/j.jmoldx.2012.09.004] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 08/10/2012] [Accepted: 09/06/2012] [Indexed: 11/20/2022] Open
|
193
|
Arya SK, Wang KY, Wong CC, Rahman ARA. Anti-EpCAM modified LC-SPDP monolayer on gold microelectrode based electrochemical biosensor for MCF-7 cells detection. Biosens Bioelectron 2013; 41:446-51. [DOI: 10.1016/j.bios.2012.09.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 08/27/2012] [Accepted: 09/05/2012] [Indexed: 12/22/2022]
|
194
|
Microfluidic Paper-Based Analytical Devices (μPADs) and Micro Total Analysis Systems (μTAS): Development, Applications and Future Trends. Chromatographia 2013; 76:1201-1214. [PMID: 24078738 PMCID: PMC3779795 DOI: 10.1007/s10337-013-2413-y] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 12/26/2012] [Accepted: 01/30/2013] [Indexed: 01/09/2023]
Abstract
Microfluidic paper-based analytical devices and micro total analysis systems are relatively new group of analytical tools, capable of analyzing complex biochemical samples containing macromolecules, proteins, nucleic acids, toxins, cells or pathogens. Within one analytical run, fluidic manipulations like transportation, sorting, mixing or separation are available. Recently, microfluidic devices are a subject of extensive research, mostly for fast and non-expensive biochemical analysis but also for screening of medical samples and forensic diagnostics. They are used for neurotransmitter detection, cancer diagnosis and treatment, cell and tissue culture growth and amplification, drug discovery and determination, detection and identification of microorganisms. This review summarizes development history, basic fabrication methods, applications and also future development trends for production of such devices.
Collapse
|
195
|
Li P, Stratton ZS, Dao M, Ritz J, Huang TJ. Probing circulating tumor cells in microfluidics. LAB ON A CHIP 2013; 13:602-9. [PMID: 23306378 PMCID: PMC3990734 DOI: 10.1039/c2lc90148j] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Circulating tumor cells (CTCs) are important targets for study as we strive to better understand, diagnose, and treat cancers. However, CTCs are found in blood at extremely low concentrations; this makes isolation, enrichment, and characterization of CTCs technically challenging. Recently, the development of CTC separation devices has grown rapidly in both academia and industry. Part of this development effort centered on microfluidic platforms, exploiting the advantages of microfluidics to improve CTC separation performance and device integration. In this Focus article, we highlight some of the recent work in microfluidic CTC separation and detection systems and discuss our appraisal of what the field should do next.
Collapse
Affiliation(s)
- Peng Li
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Zackary S. Stratton
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Ming Dao
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jerome Ritz
- Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Tony Jun Huang
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| |
Collapse
|
196
|
Hou S, Zhao L, Shen Q, Yu J, Ng C, Kong X, Wu D, Song M, Shi X, Xu X, OuYang WH, He R, Zhao XZ, Lee T, Brunicardi FC, Garcia MA, Ribas A, Lo RS, Tseng HR. Polymer Nanofiber-Embedded Microchips for Detection, Isolation, and Molecular Analysis of Single Circulating Melanoma Cells. Angew Chem Int Ed Engl 2013. [DOI: 10.1002/ange.201208452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
197
|
Hou HW, Warkiani ME, Khoo BL, Li ZR, Soo RA, Tan DSW, Lim WT, Han J, Bhagat AAS, Lim CT. Isolation and retrieval of circulating tumor cells using centrifugal forces. Sci Rep 2013. [PMID: 23405273 DOI: 10.1038/srep01259
] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Presence and frequency of rare circulating tumor cells (CTCs) in bloodstreams of cancer patients are pivotal to early cancer detection and treatment monitoring. Here, we use a spiral microchannel with inherent centrifugal forces for continuous, size-based separation of CTCs from blood (Dean Flow Fractionation (DFF)) which facilitates easy coupling with conventional downstream biological assays. Device performance was optimized using cancer cell lines (> 85% recovery), followed by clinical validation with positive CTCs enumeration in all samples from patients with metastatic lung cancer (n = 20; 5-88 CTCs per mL). The presence of CD133⁺ cells, a phenotypic marker characteristic of stem-like behavior in lung cancer cells was also identified in the isolated subpopulation of CTCs. The spiral biochip identifies and addresses key challenges of the next generation CTCs isolation assay including antibody independent isolation, high sensitivity and throughput (3 mL/hr); and single-step retrieval of viable CTCs.
Collapse
Affiliation(s)
- Han Wei Hou
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
198
|
Hou HW, Warkiani ME, Khoo BL, Li ZR, Soo RA, Tan DSW, Lim WT, Han J, Bhagat AAS, Lim CT. Isolation and retrieval of circulating tumor cells using centrifugal forces. Sci Rep 2013; 3:1259. [PMID: 23405273 PMCID: PMC3569917 DOI: 10.1038/srep01259] [Citation(s) in RCA: 506] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/28/2013] [Indexed: 12/12/2022] Open
Abstract
Presence and frequency of rare circulating tumor cells (CTCs) in bloodstreams of cancer patients are pivotal to early cancer detection and treatment monitoring. Here, we use a spiral microchannel with inherent centrifugal forces for continuous, size-based separation of CTCs from blood (Dean Flow Fractionation (DFF)) which facilitates easy coupling with conventional downstream biological assays. Device performance was optimized using cancer cell lines (> 85% recovery), followed by clinical validation with positive CTCs enumeration in all samples from patients with metastatic lung cancer (n = 20; 5-88 CTCs per mL). The presence of CD133⁺ cells, a phenotypic marker characteristic of stem-like behavior in lung cancer cells was also identified in the isolated subpopulation of CTCs. The spiral biochip identifies and addresses key challenges of the next generation CTCs isolation assay including antibody independent isolation, high sensitivity and throughput (3 mL/hr); and single-step retrieval of viable CTCs.
Collapse
Affiliation(s)
- Han Wei Hou
- Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
199
|
Das T, Chakraborty S. Perspective: Flicking with flow: Can microfluidics revolutionize the cancer research? BIOMICROFLUIDICS 2013; 7:11811. [PMID: 24403993 PMCID: PMC3574074 DOI: 10.1063/1.4789750] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/20/2012] [Indexed: 06/01/2023]
Abstract
According to the World Health Organization, cancer is one of the leading causes of death worldwide. Cancer research, in its all facets, is truly interdisciplinary in nature, cutting across the fields of fundamental and applied sciences, as well as biomedical engineering. In recent years, microfluidics has been applied successfully in cancer research. There remain, however, many elusive features of this disease, where microfluidic systems could throw new lights. In addition, some inherent features of microfluidic systems remain unexploited in cancer research. In this article, we first briefly review the advancement of microfluidics in cancer biology. We then describe the biophysical aspects of cancer and outline how microfluidic system could be useful in developing a deeper understanding on the underlying mechanisms. We next illustrate the effects of the confined environment of microchannel on cellular dynamics and argue that the tissue microconfinement could be a crucial facet in tumor development. Lastly, we attempt to highlight some of the most important problems in cancer biology, to inspire next level of microfluidic applications in cancer research.
Collapse
Affiliation(s)
- Tamal Das
- Department of New Materials and Biosystems, Max Planck Institute for Intelligent Systems, Stuttgart 70569, Germany
| | - Suman Chakraborty
- Department of Mechanical Engineering, Indian Institute for Technology Kharagpur, Kharagpur 721302, India
| |
Collapse
|
200
|
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.
Collapse
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
| |
Collapse
|