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Reginacova K, Pospisilova E, Kubecova M, Svobodova P, Bobek V, Kolostova K. Circulating tumor cells in patients with cervical cancer undergoing chemoradiotherapy combined with brachytherapy. Am J Cancer Res 2024; 14:3614-3625. [PMID: 39113856 PMCID: PMC11301293 DOI: 10.62347/qixj7103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 05/11/2024] [Indexed: 08/10/2024] Open
Abstract
Circulating tumor cells (CTCs) have significant potential to become an important tool for monitoring the effects of treatment in solid tumors. The present study reports the occurance of CTCs in cervical cancer (CC) patients during radical chemoradiotherapy (CRT), including brachytherapy (BRT), and during the follow-up period. Patients diagnosed with CC treated with radical CRT were included in the study (n=30). A total of 167 CTC-tests (MetaCell®) were provided at predefined testing time points during the study follow-up (e.g., before CRT, after CRT, every three months of follow-up). In parallel with CTC-testing, SCC-Ag were measured to compare their predictive values during treatment. CTCs were present in 96% (25/26) of patients at the time of diagnosis and in 61% (14/23) after treatment. Patients who relapsed during the 36-month follow-up (n=10) showed an elevation in pre-treatment CTC- numbers, similarly there was a significant increase in pre-treatment SCC-Ag. As next, an increased number of CTCs was observed approximately 12 weeks before relapse was diagnosed by standard imaging modalities (MRI, US, PET-CT) in 3 of 4 patients. In addition to standardized vital cytomorphology of enriched CTCs, quantitative PCR (qPCR) was used to inform the nature of CTCs before treatment. Analysis revealed increased SOX2 and POUSF expression in CTCs in the group of patients with recurrence (P < 0.02). Disease aggressiveness may be related to increased expression of stem cell markers, as found in samples from relapsed patients. CTCs may be an aid to assess tumor burden and disease aggressiveness. An increase in CTCs precedes an increase in SCC-Ag and confirmation of relapse by imaging, as shown in our study.
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Affiliation(s)
- Klaudia Reginacova
- Department of Oncology, The Third Faculty of Medicine, Charles University Prague and Faculty Hospital Kralovske VinohradySrobarova 50, 100 34 Prague 10, Czech Republic
| | - Eliska Pospisilova
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske VinohradySrobarova 50, 100 34 Prague 10, Czech Republic
| | - Martina Kubecova
- Department of Oncology, The Third Faculty of Medicine, Charles University Prague and Faculty Hospital Kralovske VinohradySrobarova 50, 100 34 Prague 10, Czech Republic
| | - Pavla Svobodova
- Department of Gynaecology, Military University Hospital and The Third Faculty of MedicineU Vojenske Nemocnice 1200, 169 02 Prague 6, Czech Republic
| | - Vladimir Bobek
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske VinohradySrobarova 50, 100 34 Prague 10, Czech Republic
- Department of Gynaecology, Military University Hospital and The Third Faculty of MedicineU Vojenske Nemocnice 1200, 169 02 Prague 6, Czech Republic
- Department of Thoracic Surgery, Krajská zdravotní a.s. Hospital41100 Ústí nad Labem, Czech Republic
- 3 Department of Surgery, 1 Faculty of Medicine Charles UniversityV Uvalu 84, 150 06 Prague 5, Czech Republic
- Department of Thoracic Surgery, Lower Silesian Oncology, Pulmonology and Hematology Center and Technical University WroclawPlac Ludwika Hirszfelda 12, 534 13 Wrocław, Poland
| | - Katarina Kolostova
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske VinohradySrobarova 50, 100 34 Prague 10, Czech Republic
- Department of Gynaecology, Military University Hospital and The Third Faculty of MedicineU Vojenske Nemocnice 1200, 169 02 Prague 6, Czech Republic
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Li W, Zhang X, Yang Y, Lin J, Zhou K, Sun R, Dang C, Diao D. Circulating tumor cells are a good predictor of tumor recurrence in clinical patients with gastric cancer. Sci Rep 2024; 14:12758. [PMID: 38830909 PMCID: PMC11148116 DOI: 10.1038/s41598-024-63305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024] Open
Abstract
Circulating tumor cells (CTCs) as a liquid biopsy have great potential in clinical applications and basic cancer research, but their clinical use in gastric cancer remains unclear. This study investigated whether CTCs could be used as a potential prognosis predictor in patients with gastric cancer. A total of 120 patients with pathologically confirmed gastric cancer were enrolled from January 1, 2015, to December 1, 2019. All patients were initially diagnosed without previous treatment, and then the number of CTCs was detected using the NEimFISH method before radical surgical resection. Regular follow-up was performed in all patients, and the correlations between the number of CTCs and clinical endpoints, such as disease-free survival (DFS) and overall survival (OS), were evaluated. The univariate and multivariate hazard ratios were calculated using the Cox proportional hazard model. Based on the number of CTCs, we defined CTCs ≥ 2 per 7.5 mL of whole blood as the positive group and CTCs < 2 as the negative group. Among the 120 patients who underwent CTC detection before surgery, the rate of CTC-positive patients was 64.17% (77/120) of which stage I and II patients accounted for 22.50% and stage III patients accounted for 41.67% (P = 0.014). By detecting CTCs before surgery and at the time of recurrence, the number of CTCs tends to increase concomitantly with disease progression (median: 2 VS 5 per 7.5 mL). Multivariate analysis showed that age (HR, 0.259; 95% CI, 0.101-0.662; P = 0.005), D-dimer (HR, 3.146; 95% CI, 1.169-8.461; P = 0.023), and lymph node metastasis (HR, 0.207; 95% CI, 0.0071-0.603; P = 0.004) were factors correlated with CTCs. In addition, the median follow-up of all the patients was 38.0 months (range of 28-80 months); the DFS in CTC-positive patients was significantly shorter than that of the CTC-negative patients, and a significant difference was found based on the Cox proportional hazard regression model analysis (44.52 ± 2.83 m vs. 74.99 ± 2.78 m, HR = 4.550, P = 0.018). The OS was shorter in the CTC-positive group than in the CTC-negative group before the operation, but the result was not significant based on the Cox proportional hazard regression model analysis (47.58 ± 2.46 m vs. 70.68 ± 3.53 m, HR = 2.261, P = 0.083). The number of CTCs tends to increase concomitantly with disease progression. In addition, the detection of CTCs was an independent predictor of shorter DFS in gastric cancer. However, the relationship between CTCs and OS needs to be determined in future studies.
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Affiliation(s)
- Wenxing Li
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Xin Zhang
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Yanqi Yang
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Jinhe Lin
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Kai Zhou
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Ruifang Sun
- Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Chengxue Dang
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Dongmei Diao
- Department of Surgical Oncology, Xi'an Jiaotong University Medical College First Affiliated Hospital, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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Nian M, Chen B, He M, Hu B. A Cascaded Phase-Transfer Microfluidic Chip with Magnetic Probe for High-Activity Sorting, Purification, Release, and Detection of Circulating Tumor Cells. Anal Chem 2024; 96:766-774. [PMID: 38158582 DOI: 10.1021/acs.analchem.3c03971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Microfluidic chips have emerged as a promising tool for sorting and enriching circulating tumor cells (CTCs) in blood, while the efficacy and purity of CTC sorting greatly depend on chip design. Herein, a novel cascaded phase-transfer microfluidic chip was developed for high-efficiency sorting, purification, release, and detection of MCF-7 cells (as a model CTC) in blood samples. MCF-7 cells were specifically captured by EpCAM aptamer-modified magnetic beads and then introduced into the designed cascaded phase-transfer microfluidic chip that consisted of three functional regions (sorting, purification, and release zone). In the sorting zone, the MCF-7 cells moved toward the inner wall of the channel and entered the purification zone for primary separation from white blood cells; in the purification zone, the MCF-7 cells were transferred to the phosphate-buffered saline flow under the interaction of Dean forces and central magnetic force, achieving high purification of MCF-7 cells from blood samples; in the release zone, MCF-7 cells were further transferred into the nuclease solution and fixed in groove by the strong magnetic force and hydrodynamic force, and the continuously flowing nuclease solution cleaved the aptamer on the trapped MCF-7 cells, causing gentle release of MCF-7 cells for subsequent inductively coupled plasma mass spectrometry (ICP-MS) detection or further cultivation. By measurement of the endogenous element Zn in the cells using ICP-MS for cell counting, an average cell recovery of 84% for MCF-7 cells was obtained in spiked blood samples. The developed method was applied in the analysis of real blood samples from healthy people and breast cancer patients, and CTCs were successfully detected in all tested patient samples (16/16). Additionally, the removal of the magnetic probes on the cell surface significantly improved cell viability up to 99.3%. Therefore, the developed cascaded phase-transfer microfluidic chip ICP-MS system possessed high integration for CTCs analysis with high cell viability, cell recovery, and purity, showing great advantages in early clinical cancer diagnosis.
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Affiliation(s)
- Miaoxiang Nian
- Department of Chemistry, Wuhan University, Wuhan 430072, China
| | - Beibei Chen
- Department of Chemistry, Wuhan University, Wuhan 430072, China
| | - Man He
- Department of Chemistry, Wuhan University, Wuhan 430072, China
| | - Bin Hu
- Department of Chemistry, Wuhan University, Wuhan 430072, China
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Law KS, Huang CE, Chen SW. Detection of Circulating Tumor Cell-Related Markers in Gynecologic Cancer Using Microfluidic Devices: A Pilot Study. Int J Mol Sci 2023; 24:ijms24032300. [PMID: 36768623 PMCID: PMC9916469 DOI: 10.3390/ijms24032300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
The detection of circulating tumor cells (CTCs) is an emerging strategy for the early detection, prognostication, and identification of recurrent cancer. The clinical utility of CTC detection has been established, but few studies have employed this strategy for the detection of gynecologic cancers. Here, we present a novel, biochip-based microfluidic device for the detection of CTCs in gynecologic cancers. The study cohort included three patients with cervical cancer, eight with endometrial cancer, two with ovarian cancer, two with breast cancer, and one with vaginal small cell carcinoma. Four cancer type-specific molecular markers (PanCK, GATA3, HER2, and HE4), as well as CD13, were used for prognostication and recurrence detection, along with downstream genomic analysis. GATA3 and HER2 were markedly expressed in the patients with cervical cancer, and this expression was strongly correlated with the early detection of recurrent disease. All four molecular markers were expressed preoperatively in the patients with endometrial cancer, and the re-expression of different markers was observed at follow-up before recurrence was confirmed. CD13 was identified as an alternative prognostic marker for both cervical and endometrial cancer. Our pilot study indicated that the novel CTC detection system can be used for prognostication and early detection of disease recurrence, which needed further investigation.
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Affiliation(s)
- Kim-Seng Law
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, 145 Xingda Road, Taichung City 40277, Taiwan
- Department of Obstetrics Gynecology, Tung’s Taichung Metroharbor Hospital, 699 Taiwan Boulevard, Section 8, Wuchi, Taichung City 43522, Taiwan
- Correspondence: ; Tel.: +886-916120758
| | - Chung-Er Huang
- CytoAurora Biotechologies Inc., Hsinchu Science Park, Hsinchu 30261, Taiwan
| | - Sheng-Wen Chen
- CytoAurora Biotechologies Inc., Hsinchu Science Park, Hsinchu 30261, Taiwan
- Department of Electrical Engineering, National Chung Cheng University, Chiayi 621301, Taiwan
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The Role of Circulating Tumor Cells in the Prognosis of Local Recurrence and Local Residual Nasopharyngeal Carcinoma Undergoing Endoscopic Resection. JOURNAL OF ONCOLOGY 2022; 2022:1453792. [PMID: 36131792 PMCID: PMC9484918 DOI: 10.1155/2022/1453792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/05/2022] [Accepted: 08/13/2022] [Indexed: 11/28/2022]
Abstract
Purpose To investigate the role of circulating tumor cells in the prognosis of local recurrence and local residual nasopharyngeal carcinoma undergoing endoscopic surgery. Methods A total of 56 patients with locally residual nasopharyngeal carcinoma (NPC) who underwent nasal endoscopic surgery from August 2018 to December 2021 were included. The status of circulating tumor cells (CTC) before and after surgery was detected, and its relationship with clinical characteristics and postoperative survival was analyzed. Results After nasal endoscopy, the positive rates of CTC and mesenchymal CTC (MCTC) detected in patients with nasopharyngeal carcinoma were significantly lower than those before treatment (P=0.0376; P=0.0212). Before nasal endoscopy, the status of CTC and MCTC was significantly correlated with the T stage (P < 0.05). After nasal endoscopy, the status of CTC and MCTC was significantly correlated with the TNM stage, T stage, and first radiotherapy mode (P < 0.05). The PFS of patients with different clinical characteristics was analyzed, and the results showed that the PFS of NPC patients with CTC (+) was significantly shorter than that of CTC (−) patients (18.71 vs. 22.47, P < 0.05) and the PFS of NPC patients with MCTC (+) was significantly shorter than that of MCTC (−) patients (18.22 vs. 22.30, P < 0.05). The PFS of NPC patients in TNM stage (I-II) was significantly longer than that in TNM stage (III) patients (22.53 vs. 18.57, P < 0.05). The PFS of NPC patients whose first radiotherapy mode was conventional was significantly longer than that of patients whose first radiotherapy mode was enhanced (22.14 vs. 16.85, P < 0.05). The COX analysis showed that MCTC and TNM stages were independent risk factors affecting the prognosis of local recurrence or local residual nasopharyngeal carcinoma after endoscopic resection (P < 0.05). Conclusion The detection of CTC is helpful for the prognosis evaluation of local recurrence or local residual NPC after endoscopic resection of NPC. The MCTC is an important factor affecting the prognosis of NPC patients.
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Chen W, Xiu S, Xie X, Guo H, Xu Y, Bai P, Xia X. Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer. Radiat Oncol 2022; 17:6. [PMID: 35012582 PMCID: PMC8751300 DOI: 10.1186/s13014-021-01978-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the prognostic relevance of specific measurement parameters such as tumor diameter, tumor volume, tumor volume reduction rate (TVRR), and changes in the squamous cell carcinoma antigen (SCC-Ag) level in patients with locally-advanced cervical cancer (LACC) undergoing concurrent radiotherapy and chemotherapy. METHODS This was a retrospective study of 203 patients with stage IIA-IVA cervical squamous cell carcinoma who were newly diagnosed at our hospital between January 2011 and March 2015. Clinical data and pre-and post-treatment imaging information were collected and each parameter was calculated using 3DSlicer software. The pre/post-treatment tumor diameter (TDpre/post), tumor volume (TVpre/post), SCC-Ag (SCCpre/post), and TVRR, SCC-Ag reduction rate (SCCRR) were analyzed and their prognostic relevance evaluated. RESULTS The median follow-up was 69 months. The 5-year overall survival (OS) and disease progression-free survival (PFS) rates were 69.5% and 64.5%, respectively. On univariate analysis, TDpre/post, TVpre/post, TVRR, SCCpre/post and SCCRR showed significant association with OS and PFS (P < 0.05). On multivariate analysis, TDpre [Hazard ratio (HR) = 0.373, P = 0.028], TDpost (HR = 0.376, P = 0.003) and SCCpost (HR = 0.374, P = 0.001) were independent predictors of OS. TVRR (HR = 2.998, P < 0.001), SCCpre (HR = 0.563, P = 0.041), and SCCpost (HR = 0.253, P < 0.001) were independent predictors of PFS. Tumor measurement parameters showed a positive correlation with SCC-Ag (P < 0.05). CONCLUSION TDpre/post, TVpre/post, TVRR, SCCpre/post, and SCCRR were prognostic factors in LACC. TDpre/post and SCCpost showed the most significant prognostic value. TVRR and SCCpre/post were closely related to disease progression. Further studies should investigate the correlation between measurement parameters of tumor and SCC-Ag.
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Affiliation(s)
- Wenjuan Chen
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China.
| | - Siyi Xiu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
| | - Xingyun Xie
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
| | - Huiming Guo
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
| | - Yuanji Xu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
| | - Penggang Bai
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
| | - Xiaoyi Xia
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350000, Fujian, China
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Molecular Markers to Predict Prognosis and Treatment Response in Uterine Cervical Cancer. Cancers (Basel) 2021; 13:cancers13225748. [PMID: 34830902 PMCID: PMC8616420 DOI: 10.3390/cancers13225748] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 02/07/2023] Open
Abstract
Uterine cervical cancer is one of the leading causes of cancer-related mortality in women worldwide. Each year, over half a million new cases are estimated, resulting in more than 300,000 deaths. While less-invasive, fertility-preserving surgical procedures can be offered to women in early stages, treatment for locally advanced disease may include radical hysterectomy, primary chemoradiotherapy (CRT) or a combination of these modalities. Concurrent platinum-based chemoradiotherapy regimens remain the first-line treatments for locally advanced cervical cancer. Despite achievements such as the introduction of angiogenesis inhibitors, and more recently immunotherapies, the overall survival of women with persistent, recurrent or metastatic disease has not been extended significantly in the last decades. Furthermore, a broad spectrum of molecular markers to predict therapy response and survival and to identify patients with high- and low-risk constellations is missing. Implementation of these markers, however, may help to further improve treatment and to develop new targeted therapies. This review aims to provide comprehensive insights into the complex mechanisms of cervical cancer pathogenesis within the context of molecular markers for predicting treatment response and prognosis.
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Liquid Biopsy in Cervical Cancer: Hopes and Pitfalls. Cancers (Basel) 2021; 13:cancers13163968. [PMID: 34439120 PMCID: PMC8394398 DOI: 10.3390/cancers13163968] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/03/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Cervical cancer is the fourth most common cancer in women worldwide, and its incidence is variably distributed between developed and less-resourced countries, in which socio-economic issues and religious beliefs often limit the widespread diffusion and the access to screening campaigns. In the “liquid biopsy” era, the application of non-invasive and repeatable techniques to the identification of diagnostic, prognostic, and predictive biomarkers might facilitate the management of this disease and, hopefully, improve its outcome. The purpose of this review is to explore the progress status of liquid biopsy in cervical cancer patients. Several methods are described, which include the analysis of circulating tumor cells, the search for pathogenic mutations on circulating tumor DNA, as well as the identification of circulating RNAs, focusing on their potential clinical applications and current limitations. Abstract Cervical cancer (CC) is the fourth most common cancer in women worldwide, with about 90% of cancer-related deaths occurring in developing countries. The geographical influence on disease evolution reflects differences in the prevalence of human papilloma virus (HPV) infection, which is the main cause of CC, as well as in the access and quality of services for CC prevention and diagnosis. At present, the most diffused screening and diagnostic tools for CC are Papanicolaou test and the more sensitive HPV-DNA test, even if both methods require gynecological practices whose acceptance relies on the woman’s cultural and religious background. An alternative (or complimentary) tool for CC screening, diagnosis, and follow-up might be represented by liquid biopsy. Here, we summarize the main methodologies developed in this context, including circulating tumor cell detection and isolation, cell tumor DNA sequencing, coding and non-coding RNA detection, and exosomal miRNA identification. Moreover, the pros and cons of each method are discussed, and their potential applications in diagnosis and prognosis of CC, as well as their role in treatment monitoring, are explored. In conclusion, it is evident that despite many advances obtained in this field, further effort is needed to validate and standardize the proposed methodologies before any clinical use.
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Takakura M, Takata E, Sasagawa T. A Novel Liquid Biopsy Strategy to Detect Small Amounts of Cancer Cells Using Cancer-Specific Replication Adenoviruses. J Clin Med 2020; 9:jcm9124044. [PMID: 33327605 PMCID: PMC7765046 DOI: 10.3390/jcm9124044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/26/2022] Open
Abstract
Circulating tumor cells (CTCs) are a promising source of clinical and biological cancer information and can be a material for liquid biopsy. However, detecting and capturing these cells remains a challenge. Various biological factors (e.g., cell surface proteins, cell size, deformability, or dielectrophoresis) have been applied to detect CTCs. Cancer cells dramatically change their characteristics during tumorigenesis and metastasis. Hence, defining a cell as malignant using such a parameter is difficult. Moreover, immortality is an essential characteristic of cancer cells. Telomerase elongates telomeres and plays a critical role in cellular immortality and is specifically activated in cancer cells. Thus, the activation of telomerase can be a good fingerprint for cancer cells. Telomerase cannot be recognized by antibodies in living cells because it is a nuclear enzyme. Therefore, telomerase-specific replication adenovirus, which expresses the green fluorescent protein, has been applied to detect CTCs. This review explores the overview of this novel technology and its application in gynecological cancers.
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