Micro/nanofluidic technologies for efficient isolation and detection of circulating tumor cells

Recent advances in nano/microfluidics-based cell isolation techniques for cancer diagnosis and treatments

Miniaturization has improved significantly in the recent decade, which has enabled the development of numerous microfluidic systems. Microfluidic technologies have shown great potential for separating desired cells from heterogeneous samples, as they offer benefits such as low sample consumption, easy operation, and high separation accuracy. Microfluidic cell separation approaches can be classified into physical (label-free) and biological (labeled) methods based on their working principles. Each method has remarkable and feasible benefits for the purposes of cancer detection and therapy, as well as the challenges that we have discussed in this article. In this review, we present the recent advances in microfluidic cell sorting techniques that incorporate both physical and biological aspects, with an emphasis on the methods by which the cells are separated. We first introduce and discuss the biological cell sorting techniques, followed by the physical cell sorting techniques. Additionally, we explore the role of microfluidics in drug screening, drug delivery, and lab-on-chip (LOC) therapy. In addition, we discuss the challenges and future prospects of integrated microfluidics for cell sorting.

Droplet Microfluidics for Current Cancer Research: From Single-Cell Analysis to 3D Cell Culture

Cancer is the second leading cause of death worldwide. Differences in drug resistance and treatment response caused by the heterogeneity of cancer cells are the primary reasons for poor cancer therapy outcomes in patients. In addition, current in vitro anticancer drug-screening methods rely on two-dimensional monolayer-cultured cancer cells, which cannot accurately predict drug behavior in vivo. Therefore, a powerful tool to study the heterogeneity of cancer cells and produce effective in vitro tumor models is warranted to leverage cancer research. Droplet microfluidics has become a powerful platform for the single-cell analysis of cancer cells and three-dimensional cell culture of in vitro tumor spheroids. In this review, we discuss the use of droplet microfluidics in cancer research. Droplet microfluidic technologies, including single- or double-emulsion droplet generation and passive- or active-droplet manipulation, are concisely discussed. Recent advances in droplet microfluidics for single-cell analysis of cancer cells, circulating tumor cells, and scaffold-free/based 3D cell culture of tumor spheroids have been systematically introduced. Finally, the challenges that must be overcome for the further application of droplet microfluidics in cancer research are discussed.

Faraday cage-type ECL biosensor for the detection of circulating tumor cell MCF-7

Herein, a Faraday cage-type electrochemiluminescence biosensor was designed for the detection of human breast cancer cell MCF-7. Two kinds of nanomaterials, Fe₃O₄-APTs and GO@PTCA-APTs, were synthesized as capture unit and signal unit, respectively. In presence of the target MCF-7, the Faraday cage-type electrochemiluminescence biosensor was constructed by forming a complex "capture unit-MCF-7-signal unit". In this case, lots of electrochemiluminescence signal probes were assembled and could participate in the electrode reaction, achieving a significant increase in sensitivity. In addition, the double aptamer recognition strategy was adopted to improve the capture, enrichment efficiency and detection reliability. Under optimal experimental conditions, the limit of detection was 3 cells/mL. And, the sensor could afford the detection of actual human blood samples, which is the first report on the detection of intact circulating tumor cells by the Faraday cage-type electrochemiluminescence biosensor.

Droplet microfluidics for CTC-based liquid biopsy: a review

Circulating tumor cells (CTCs) are important biomarkers of liquid biopsy. The number and heterogeneity of CTCs play an important role in cancer diagnosis and personalized medicine. However, owing to the low-abundance biomarkers of CTCs, conventional assays are only able to detect CTCs at the population level. Therefore, there is a pressing need for a highly sensitive method to analyze CTCs at the single-cell level. As an important branch of microfluidics, droplet microfluidics is a high-throughput and sensitive single-cell analysis platform for the quantitative detection and heterogeneity analysis of CTCs. In this review, we focus on the quantitative detection and heterogeneity analysis of CTCs using droplet microfluidics. Technologies that enable droplet microfluidics, particularly high-throughput droplet generation and high-efficiency droplet manipulation, are first discussed. Then, recent advances in detecting and analyzing CTCs using droplet microfluidics from the different aspects of nucleic acids, proteins, and metabolites are introduced. The purpose of this review is to provide guidance for the continued study of droplet microfluidics for CTC-based liquid biopsy.

Microfluidic Systems for Blood and Blood Cell Characterization

A laboratory blood test is vital for assessing a patient's health and disease status. Advances in microfluidic technology have opened the door for on-chip blood analysis. Currently, microfluidic devices can reproduce myriad routine laboratory blood tests. Considerable progress has been made in microfluidic cytometry, blood cell separation, and characterization. Along with the usual clinical parameters, microfluidics makes it possible to determine the physical properties of blood and blood cells. We review recent advances in microfluidic systems for measuring the physical properties and biophysical characteristics of blood and blood cells. Added emphasis is placed on multifunctional platforms that combine several microfluidic technologies for effective cell characterization. The combination of hydrodynamic, optical, electromagnetic, and/or acoustic methods in a microfluidic device facilitates the precise determination of various physical properties of blood and blood cells. We analyzed the physical quantities that are measured by microfluidic devices and the parameters that are determined through these measurements. We discuss unexplored problems and present our perspectives on the long-term challenges and trends associated with the application of microfluidics in clinical laboratories. We expect the characterization of the physical properties of blood and blood cells in a microfluidic environment to be considered a standard blood test in the future.

Refining of Particulates at Stimuli-Responsive Interfaces: Label-Free Sorting and Isolation

The mechanism of separation methods, for example, liquid chromatography, is realized through rapid multiple adsorption-desorption steps leading to the dynamic equilibrium state in a mixture of molecules with different partition coefficients. Sorting of colloidal particles, including protein complexes, cells, and viruses, is limited due to a high energy barrier, up to millions kT, required to detach particles from the interface, which is in dramatic contrast to a few kT for small molecules. Such a strong interaction renders particle adsorption quasi-irreversible. The dynamic adsorption-desorption equilibrium is approached very slowly, if ever attainable. This limitation is alleviated with a local oscillating repulsive mechanical force generated at the microstructured stimuli-responsive polymer interface to switch between adsorption and mechanical-force-facilitated desorption of the particles. Such a dynamic regime enables the separation of colloidal mixtures based on the particle-polymer interface affinity, and it could find use in research, diagnostics, and industrial-scale label-free sorting of highly asymmetric mixtures of colloids and cells.

Toward the Development of Rapid, Specific, and Sensitive Microfluidic Sensors: A Comprehensive Device Blueprint

Recent advances in nano/microfluidics have led to the miniaturization of surface-based chemical and biochemical sensors, with applications ranging from environmental monitoring to disease diagnostics. These systems rely on the detection of analytes flowing in a liquid sample, by exploiting their innate nature to react with specific receptors immobilized on the microchannel walls. The efficiency of these systems is defined by the cumulative effect of analyte detection speed, sensitivity, and specificity. In this perspective, we provide a fresh outlook on the use of important parameters obtained from well-characterized analytical models, by connecting the mass transport and reaction limits with the experimentally attainable limits of analyte detection efficiency. Specifically, we breakdown when and how the operational (e.g., flow rates, channel geometries, mode of detection, etc.) and molecular (e.g., receptor affinity and functionality) variables can be tailored to enhance the analyte detection time, analytical specificity, and sensitivity of the system (i.e., limit of detection). Finally, we present a simple yet cohesive blueprint for the development of high-efficiency surface-based microfluidic sensors for rapid, sensitive, and specific detection of chemical and biochemical analytes, pertinent to a variety of applications.

State-of-the-arts techniques and current evolving approaches in the separation and detection of circulating tumor cell

Circulating tumor cells (CTCs) are cancer cells that shed from the primary tumor and then enter the circulatory system, a small part of which may evolve into metastatic cancer under appropriate microenvironment conditions. The detection of CTCs is a truly noninvasive, dynamic monitor for disease changes, which has considerable clinical implications in the selection of targeted drugs. However, their inherent rarity and heterogeneity pose significant challenges to their isolation and detection. Even the "gold standard", CellSearch™, suffers from high expenses, low capture efficiency, and the consumption of time. With the advancement of CTCs analysis technologies in recent years, the yield and efficiency of CTCs enrichment have gradually been improved, as well as detection sensitivity. In this review, the isolation and detection strategies of CTCs have been completely described and the potential directions for future research and development have also been highlighted through analyzing the challenges faced by current strategies.

EGFR mutation detection of lung circulating tumor cells using a multifunctional microfluidic chip

Microfluidics has become a reliable platform for circulating tumor cells (CTCs) detection because of its high integration, small size, low consumption of reagents and rapid response. Here, we developed a multifunctional microfluidic device consists of three parts, including CTCs capture area, single-layer membrane valves area, and microcavity nucleic acid detection and analysis region based on digital polymerase chain reaction (dPCR), allowing CTCs capture, lysis, and genetic characterization to be performed on a single chip. The CTCs capture chip is coupled to the nucleic acid detection chip via a control valve. CTCs were firstly trapped in the CTC capture area, and then lysed using proteinase K to release nucleic acids. Subsequently CTCs lysate was transferred into nucleic acid detection area consisting of 12800 micro-cavity chambers for nucleic acids detection. To evaluate the performance of this chip, this study detected EGFR-L858R mutation in lung cancer cell lines H1975 and A549 cells, as well as leukocytes from normal donors. The results showed that positive signals were only observed in H1975 cells, and the detected value had a high linear relationship with the expected value (R² = 0.9897). In conclusion, this multi-functional microfluidic chip that integrates CTCs capture, lysis and nucleic acid detection can successfully detect gene mutations in CTCs, providing reference for tumor-targeted drugs and precise diagnosis and treatment.

Dopamine-functionalized hyaluronic acid microspheres for effective capture of CD44-overexpressing circulating tumor cells

As one of the biomarkers of liquid biopsy, circulating tumor cells (CTCs) provides important clinical information for cancer diagnosis. However, accurate separation and identification of CTCs remains a great deal of challenge. In present work, we developed novel dopamine-functionalized hyaluronic acid microspheres (HA-DA microspheres) to capture CD44-overexpressing CTCs. The dopamine was grafted onto the hyaluronic acid chain, which was polymerized and cross-linked by oxidation of the catechol groups. Afterwards, a facile microfluidic chip was designed and developed to fabricate the HA-DA microspheres with a diameter of about 45 μm. Our results showed that the CD44+ cells (i.e., HeLa, HepG2, A549, MCF-7 and DU-145 cells) could be selectively captured. Then a double-layer microfluidic filter (DLMF) was fabricated for dynamic isolation and detection of CTCs in blood samples. Many slit openings with 15 μm in height were designed to allow white blood cells to clear away, while the microspheres with CTCs were intercepted in the DLMF, which achieved effective separation of CTCs from blood cells. The approach exhibited high capture efficiency even at the cell density as low as 10 cells/mL. We believe the DLMF integrated with HA-DA microspheres could be a promising approach for isolation and detection of CD44-overexpressing CTCs, which is useful for prognosis and early metastasis of cancer patients.

Facile synthesis of 3D hierarchical micro-/nanostructures in capillaries for efficient capture of circulating tumor cells

The efficient capture of rare circulating tumor cells (CTCs) with high viability is of great importance in cancer diagnosis. The integration of three-dimensional (3D) nanobiointerfaces with capillary flow channel platforms can efficiently improve CTC capture performance by providing abundant binding sites and increasing the likelihood of contact as samples flow through the microchannels. However, due to the complex preparation processes, facile synthesis of nanostructures for use as substrates in flow channels for biomedical applications is still challenging. To reduce the encapsulation steps in the fabricating of nanostructured flow channel devices, we chose the enclosed glass capillaries as flow channels and accomplished all the experiments in the microchannels, including 3D nanostructure synthesis, surface modification and capture/release of CTCs. In this work, we constructed a novel 3D Zn(OH)F/ZnO nanoforest array in capillaries for CTC isolation via a facile microfluidic wet chemistry method. Because of the abundant binding sites of the 3D Zn(OH)F/ZnO nanoforest array, the capture efficiency was remarkably enhanced compared with that of vertical nanowires (90.3% vs 69.1%). In addition, a high release efficiency and cell viability of released cells were achieved by grafting poly(N-isopropylacrylamide) (PNIPPAm). These results may provide evidence for a novel method to fabricate hierarchical 3D substrates with a combination of biomolecule recognition and topographical interaction for biomedical applications.

Dendrimer-Au Nanoparticle Network Covered Alumina Membrane for Ion Rectification and Enhanced Bioanalysis

Ion transport in an artificial asymmetric nanoporous membrane, which is similar to biological ion channels, can be used for biosensing. Here, a dendrimer-Au nanoparticle network (DAN) is in situ assembled on a nanoporous anodic aluminum oxide (AAO) surface, forming a DAN/AAO hybrid membrane. Benefiting from the high surface area and anion selectivity of DAN, the prepared DAN/AAO hybrid presents selective ion transport. Under a bias potential, a diode-like current-potential (I-V) response is observed. The obtained ionic current rectification (ICR) property can be tuned by the ion valence and pH value of the electrolyte. The rectified ionic current endows the as-prepared DAN/AAO hybrid with the ability of enhanced bioanalysis. Sensitive capture and detection of circulating tumor cells (CTCs) with a detection limit of 80 cells mL^-1 as well as excellent reusability can be achieved.

Dynamic Halbach array magnet integrated microfluidic system for the continuous-flow separation of rare tumor cells

Circulating tumor cells (CTCs), the most representative rare cells in peripheral blood, have received great attention due to their clinical utility in liquid biopsy. The downstream analysis of intact CTCs isolated from peripheral blood provides important clinical information for personalized medicine. However, current CTC isolation and detection methods have been challenged by their extreme rarity and heterogeneity. In this study, we developed a novel microfluidic system with a continuously moving Halbach array magnet (dHAMI microfluidic system) for negative isolation CTCs from whole blood, which aimed to capture non-target white blood cells (WBCs) and elute target CTCs. The dynamic and continuous movement of the Halbach array magnet generated a continuous magnetic force acting on the magnetic bead-labelled WBCs in the continuous-flow fluid to negatively exclude the WBCs from the CTCs. Furthermore, the continuously moving magnetic field effectively eliminated the effect of magnetic bead aggregation on the fluid flow to realize the continuous-flow separation of the CTCs without a sample loading volume limitation. The experimental procedure for CTC negative isolation using the dHAMI microfluidic system could be completed within 40 min. Under the optimized experimental conditions of the dHAMI microfluidic system, including the flow rate and concentration of the immunomagnetic bead, the average CTC capture rate over a range of spiked cell numbers (50–1000 cancer cells per mL) was up to 91.6% at a flow rate of 100 μL min⁻¹. Finally, the CTCs were successfully detected in 10 of 10 (100%) blood samples from patients with cancer. Therefore, the dHAMI microfluidic system could effectively isolate intact and heterogeneous CTCs for downstream cellular and molecular analyses, and this robust microfluidic platform with an excellent magnetic manipulation performance also has great application potential for the separation of other rare cells.

We develop a dynamic Halbach array magnet integrated microfluidic system for continuous-flow separation of circulating tumor cells from whole blood.