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Ma G, Wang J, Fu J, Chen R, Liang M, Li M, Xia T, Liu X, Wang S. Heterogeneous circulating tumor cells correlate with responses to neoadjuvant chemotherapy and prognosis in patients with locally advanced breast cancer. Breast Cancer Res Treat 2023:10.1007/s10549-023-06942-y. [PMID: 37311933 DOI: 10.1007/s10549-023-06942-y] [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: 08/05/2022] [Accepted: 04/05/2023] [Indexed: 06/15/2023]
Abstract
Neoadjuvant chemotherapy (NCT) is the standard treatment for patients with locally advanced breast cancer (LABC). The predictive value of heterogeneous circulating tumor cells (CTCs) in NCT response has not been determined. All patients were staged as LABC, and blood samples were collected at the time of biopsy, and after the first and eighth NCT courses. Patients were divided into High responders (High-R) and Low responders (Low-R) according to Miller-Payne system and changes in Ki-67 levels after NCT treatment. A novel SE-i·FISH strategy was applied to detect CTCs. Heterogeneities were successfully analyzed in patients undergoing NCT. Total CTCs increased continuously and were higher in Low-R group, while in High-R group, CTCs increased slightly during NCT before returning to baseline levels. Triploid and tetraploid chromosome 8 increased in Low-R but not High-R group. The number of small CTCs in Low-R group increased significantly until the last sample, however, remained constant in High-R group. The patients with more CTCs had shorter PFS and OS than those with less CTCs after the eighth course of NCT. Total CTCs following NCT could predict patients' responses. More detailed characterizations of CTC blood profiles may improve predictive capacity and treatments of LABC.
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Affiliation(s)
- Ge Ma
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jingyi Wang
- Department of Breast Surgery, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, 29 Xinglong Lane, Changzhou, 213003, China
| | - Jingyue Fu
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China
| | - Rui Chen
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China
| | - Mengdi Liang
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China
| | - Minghui Li
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China
| | - Tiansong Xia
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Xiaoan Liu
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China.
| | - Shui Wang
- Department of Breast Surgery, The First Affiliated Hospital With Nanjing Medical University, 300 Guang-Zhou Road, Nanjing, 210029, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Hua Y, Dong J, Hong J, Wang B, Yan Y, Li Z. Clinical applications of circulating tumor cells in hepatocellular carcinoma. Front Oncol 2022; 12:968591. [PMID: 36091119 PMCID: PMC9448983 DOI: 10.3389/fonc.2022.968591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 12/09/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a highly malignant tumor and ranked as the fourth cause of cancer-related mortality. The poor clinical prognosis is due to an advanced stage and resistance to systemic treatment. There are no obvious clinical symptoms in the early stage and the early diagnosis rate remains low. Novel effective biomarkers are important for early diagnosis and tumor surveillance to improve the survival of HCC patients. Circulating tumor cells (CTCs) are cancer cells shed from primary or metastatic tumor and extravasate into the blood system. The number of CTCs is closely related to the metastasis of various solid tumors. CTCs escape from blood vessels and settle in target organs, then form micro-metastasis. Epithelial-mesenchymal transformation (EMT) plays a crucial role in distant metastasis, which confers strong invasiveness to CTCs. The fact that CTCs can provide complete cellular biological information, which allows CTCs to be one of the most promising liquid biopsy targets. Recent studies have shown that CTCs are good candidates for early diagnosis, prognosis evaluation of metastasis or recurrence, and even a potential therapeutic target in patients with HCC. It is a new indicator for clinical application in the future. In this review, we introduce the enrichment methods and mechanisms of CTCs, and focus on clinical application in patients with HCC.
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Affiliation(s)
- Yinggang Hua
- Department of General Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jingqing Dong
- Department of General Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jinsong Hong
- Department of General Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Bailin Wang
- Department of General Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Yong Yan
- Department of General Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
- *Correspondence: Zhiming Li, ; Yong Yan,
| | - Zhiming Li
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Zhiming Li, ; Yong Yan,
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Cheng H, Wang S, Luan W, Ye X, Dou S, Tang Z, Zhu H, Lin PP, Li Y, Cui H, Chang X. Combined detection and subclass characteristics analysis of CTCs and CTECs by SE-iFISH in ovarian cancer. Chin J Cancer Res 2021; 33:256-270. [PMID: 34158744 PMCID: PMC8181871 DOI: 10.21147/j.issn.1000-9604.2021.02.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective Hematogenous metastasis is essential for the progression of ovarian cancer (OC), and circulating tumor cells (CTCs) are part of the metastatic cascade. However, the detection rate of CTC is low due to the use of less sensitive detection methods. Therefore, this study aimed to detect CTCs and circulating tumorigenic endothelial cells (CTECs) in patients with OC using subtraction enrichment and immunostaining and fluorescence in situ hybridization (SE-iFISH).
Methods We enrolled a total of 56 subjects, including 20 OC patients and 36 ovarian benign tumor patients. CTCs and CTECs were captured by subtraction enrichment (SE) and counted and classified according to immunofluorescence staining of tumor markers (TMs) carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) combined with fluorescence in situ hybridization (iFISH) of chromosome 8 (Chr8) aneuploidy. The diagnostic value and subtype characteristics of CTCs and CTECs were investigated.
Results The detection rate of CTCs by SE-iFISH was high. Compared with CA125 and HE4, Chr8 aneuploidy was the major identification feature of CTC. CTC counts in OC were statistically higher than those in benign groups. CTC and CTEC with ≥pentaploidy were detected in both groups, illustrating the poor diagnostic value of CTC or CTEC. Distributions of triploid and tetraploid CTC subtypes were significantly different, and combined detection of triploid and tetraploid CTCs showed the best diagnostic value. In contrast, the distribution of CTECs in the OC and benign groups had no statistically significant difference. Small CTCs accounted for over 1/3 of the total CTC count. We also found that small CTCs and CTECs primarily comprised triploid cells, while large CTCs and CTECs mainly comprised pentaploidy and beyond. Conclusions The application of SE-iFISH offered a more comprehensive understanding of heterogeneous CTCs and CTECs in OC. Analysis of subclass characteristics of the CTCs and CTECs according to Chr8 aneuploidy and cell size may broaden their potential clinical utility and deepen mechanistic studies in OC.
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Affiliation(s)
- Hongyan Cheng
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
| | - Shang Wang
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
| | - Wenqing Luan
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
| | - Xue Ye
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
| | - Sha Dou
- Department of Obstetrics and Gynecology
| | | | | | | | - Yi Li
- Department of Obstetrics and Gynecology
| | - Heng Cui
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
| | - Xiaohong Chang
- Department of Obstetrics and Gynecology.,Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China
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Tan J, Ding Z, Hood M, Li W. Simulation of circulating tumor cell transport and adhesion in cell suspensions in microfluidic devices. BIOMICROFLUIDICS 2019; 13:064105. [PMID: 31737154 PMCID: PMC6837944 DOI: 10.1063/1.5129787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/19/2019] [Indexed: 05/06/2023]
Abstract
Understanding cell transport and adhesion dynamics under flow is important for many biotransport problems. We investigated the influence of cell size, ligand coating density, micropost size, and intercellular collisions on circulating tumor cell adhesion and transport in microfluidic devices. The cells were modeled as coarse-grained cell membranes and the adhesion was modeled as pairwise interacting potentials, while the fluid was solved using the lattice Boltzmann method. The coupling between the cell and the fluid was achieved through the immersed boundary method. The cell showed transient rolling adhesion in high shear regions and firm adhesion in low shear regions. The adhesive force for rolling cells on a micropost was increasing before the cell reached the crest of the post and then decreasing afterward. The adhesive strength for cells increases with ligand coating density. Cell trajectories in a microfluidic device with a shifted post design were studied as well. At low concentrations, the majority of the cells follow streamlines closely. However, the intercellular collision and collision from red blood cells impacted the cell trajectories. An L 2 norm of | e | was defined to characterize the difference between the cell trajectories and the associated streamlines. It was shown that | e | L 2 increases with micropost sizes and cell concentrations.
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Affiliation(s)
- Jifu Tan
- Department of Mechanical Engineering, Northern Illinois University, DeKalb, Illinois 60115, USA
- Authors to whom correspondence should be addressed: and
| | - Zhenya Ding
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, USA
| | - Michael Hood
- Department of Mechanical Engineering, Northern Illinois University, DeKalb, Illinois 60115, USA
| | - Wei Li
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, USA
- Authors to whom correspondence should be addressed: and
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Wang Y, Liu Y, Zhang L, Tong L, Gao Y, Hu F, Lin PP, Li B, Zhang T. Vimentin expression in circulating tumor cells (CTCs) associated with liver metastases predicts poor progression-free survival in patients with advanced lung cancer. J Cancer Res Clin Oncol 2019; 145:2911-2920. [PMID: 31646374 PMCID: PMC6861204 DOI: 10.1007/s00432-019-03040-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the presence of vimentin expression in CTCs and its clinical relevance in patients with advanced lung cancer. METHODS Peripheral blood was obtained from 61 treatment-naive patients with advanced lung cancer. Subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) platform was applied to identify, enumerate and characterize CTCs based on cell size, aneuploidy of chromosome 8 (Chr8) and vimentin expression. Quantification and analysis of CTCs were performed on patients before chemotherapy administration and after two cycles of therapy. RESULTS Before treatment, CTCs were detected in 60 (98.4%) patients, small cell CTCs (≤ 5 µm of WBCs) accounted for 52.8% of the absolute CTCs number, while 12 (19.7%) of the included patients had detectable vimentin-positive CTCs (vim+ CTCs). Liver metastases were reported in 7 (11.5%) patients and were significantly correlated to the presence of Vim+ CTCs (p = 0.002), with a high positivity rate of 71.4% (5/7). Vim+ CTCs were mostly in small cell size and Chr8 aneuploidy (77.0% and 82.05%, respectively). Baseline small cell CTCs ≥ 2/6 ml, triploid CTCs ≥ 2/6 ml, Vim+ CTCs ≥ 1/6 ml were found to significantly correlate with poor progression-free survival (PFS) (p = 0.017, p = 0.009 and p = 0.001, respectively). After adjusting for clinically significant factors, baseline Vim+ CTCs ≥ 1/6 ml was the only independent predictor of poor PFS [hazard ratio (HR):2.756, 95% confidence interval (CI): 1.239-6.131; p = 0.013]. CONCLUSIONS This study demonstrates an important morphologic, karyotypic and phenotypic CTCs heterogeneity in advanced lung cancer patients. The majority of Vim+ CTCs are in small size and Chr8 aneuploidy. Baseline presence of Vim+ CTCs is correlated with liver metastases and may help predict poor PFS.
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Affiliation(s)
- Ying Wang
- Department of Cellular and Molecular Biology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China.,Department of Oncology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100043, China
| | - Yanxia Liu
- Department of Cellular and Molecular Biology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China
| | - Lina Zhang
- Department of Cellular and Molecular Biology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China
| | - Li Tong
- Department of Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China
| | - Yuan Gao
- Department of General Medicine, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China
| | - Fanbin Hu
- Department of General Medicine, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China
| | | | - Baolan Li
- Department of General Medicine, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China.
| | - Tongmei Zhang
- Department of General Medicine, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No.9, Beiguan Street, Tongzhou District, Beijing, 101149, China.
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Uchôa Guimarães CT, Ferreira Martins NN, Cristina da Silva Oliveira K, Almeida CM, Pinheiro TM, Gigek CO, Roberto de Araújo Cavallero S, Assumpção PP, Cardoso Smith MA, Burbano RR, Calcagno DQ. Liquid biopsy provides new insights into gastric cancer. Oncotarget 2018; 9:15144-15156. [PMID: 29599934 PMCID: PMC5871105 DOI: 10.18632/oncotarget.24540] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/01/2017] [Indexed: 12/12/2022] Open
Abstract
Liquid biopsies have great promise for precision medicine as they provide information about primary and metastatic tumors via a minimally invasive method. In gastric cancer patients, a large number of blood-based biomarkers have been reported for their potential role in clinical practice for screening, early diagnosis, prognostic evaluation, recurrence monitoring and therapeutic efficiency follow-up. This current review focuses on blood liquid biopsies' role and their clinical implications in gastric cancer patients, with an emphasis on circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) and circulating non-coding RNAs (ncRNAs). We also provide a brief discussion of the potential and limitations of liquid biopsies use and their future use in the routine clinical care of gastric cancer.
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Affiliation(s)
- Camila Tavares Uchôa Guimarães
- Residência Multiprofissional em Oncologia, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, PA, Brazil
| | | | | | - Caroline Martins Almeida
- Residência Multiprofissional em Oncologia, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, PA, Brazil
| | | | - Carolina Oliveira Gigek
- Disciplina de Genética, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Disciplina de Gastroenterologia Cirurgica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Rommel Rodríguez Burbano
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, PA, Brazil
- Laboratório de Biologia Molecular, Hospital Ophir Loyola, Belém, PA, Brazil
| | - Danielle Queiroz Calcagno
- Residência Multiprofissional em Oncologia, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, PA, Brazil
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, PA, Brazil
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Ferhan AR, Jackman JA, Park JH, Cho NJ, Kim DH. Nanoplasmonic sensors for detecting circulating cancer biomarkers. Adv Drug Deliv Rev 2018; 125:48-77. [PMID: 29247763 DOI: 10.1016/j.addr.2017.12.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/29/2017] [Accepted: 12/08/2017] [Indexed: 12/20/2022]
Abstract
The detection of cancer biomarkers represents an important aspect of cancer diagnosis and prognosis. Recently, the concept of liquid biopsy has been introduced whereby diagnosis and prognosis are performed by means of analyzing biological fluids obtained from patients to detect and quantify circulating cancer biomarkers. Unlike conventional biopsy whereby primary tumor cells are analyzed, liquid biopsy enables the detection of a wide variety of circulating cancer biomarkers, including microRNA (miRNA), circulating tumor DNA (ctDNA), proteins, exosomes and circulating tumor cells (CTCs). Among the various techniques that have been developed to detect circulating cancer biomarkers, nanoplasmonic sensors represent a promising measurement approach due to high sensitivity and specificity as well as ease of instrumentation and operation. In this review, we discuss the relevance and applicability of three different categories of nanoplasmonic sensing techniques, namely surface plasmon resonance (SPR), localized surface plasmon resonance (LSPR) and surface-enhanced Raman scattering (SERS), for the detection of different classes of circulating cancer biomarkers.
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Affiliation(s)
- Abdul Rahim Ferhan
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Joshua A Jackman
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Jae Hyeon Park
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Nam-Joon Cho
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, 639798, Singapore.
| | - Dong-Hwan Kim
- School of Chemical Engineering, Sungkyunkwan University, 16419, Republic of Korea.
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Haddadi H, Naghsh-Nilchi H, Di Carlo D. Separation of cancer cells using vortical microfluidic flows. BIOMICROFLUIDICS 2018; 12:014112. [PMID: 29464010 PMCID: PMC5798996 DOI: 10.1063/1.5009037] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/17/2018] [Indexed: 05/04/2023]
Abstract
Label-free separation of viable cancer cells using vortical microfluidic flows has been introduced as a feasible cell collection method in oncological studies. Besides the clinical importance, the physics of particle interactions with the vortex that forms in a wall-confined geometry of a microchannel is a relatively new area of fluid dynamics. In our previous work [Haddadi and Di Carlo, J. Fluid. Mech. 811, 436-467 (2017)], we have introduced distinct aspects of inertial flow of dilute suspensions over cavities in a microchannel such as breakdown of the separatrix and formation of stable limit cycle orbits for finite size polystyrene particles. In this work, we extend our experiments to address the engineering-physics of cancer cell entrapment in microfluidic cavities. We begin by studying the effects of the channel width and device height on the morphology of the vortex, which has not been discussed in our previous work. The stable limit cycle orbits of finite size cancer cells are then presented. We demonstrate effects of the separatrix breakdown and the limit cycle formation on the operation of the cancer cell separation platform. By studying the flow of dilute cell suspensions over the cavities, we further develop the notion of the cavity capacity and the relative rate of cell accumulation as optimization criteria which connect the device geometry with the flow. Finally, we discuss the proper placement of multiple cavities inside a microchannel for improved cell entrapment.
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Affiliation(s)
- Hamed Haddadi
- Department of Bioengineering, University of California at Los Angeles, 420 Westwood Plaza, Los Angeles, California 90095, USA
| | - Hamed Naghsh-Nilchi
- Department of Bioengineering, University of California at Los Angeles, 420 Westwood Plaza, Los Angeles, California 90095, USA
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Wang L, Li Y, Xu J, Zhang A, Wang X, Tang R, Zhang X, Yin H, Liu M, Wang DD, Lin PP, Shen L, Dong J. Quantified postsurgical small cell size CTCs and EpCAM + circulating tumor stem cells with cytogenetic abnormalities in hepatocellular carcinoma patients determine cancer relapse. Cancer Lett 2017; 412:99-107. [PMID: 29031565 DOI: 10.1016/j.canlet.2017.10.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/02/2017] [Accepted: 10/06/2017] [Indexed: 12/12/2022]
Abstract
Detection of hepatocellular carcinoma circulating tumor cells performed with conventional strategies, is significantly limited due to inherently heterogeneous and dynamic expression of EpCAM, as well as degradation of cytokeratins during epithelial-to-mesenchymal transition, which inevitably lead to non-negligible false negative detection of such "uncapturable and invisible" CTCs. A novel SE-iFISH strategy, improved for detection of HCC CTCs in this study, was applied to comprehensively detect, in situ phenotypically and karyotypically characterize hepatocellular and cholangiocarcinoma CTCs (CD45-/CD31-) in patients subjected to surgical resection. Clinical significance of diverse subtypes of CTC was systematically investigated. Existence of small cell size CTCs (≤5 μm of WBCs) with cytogenetic abnormality of aneuploid chromosome 8, which constituted majority of the detected CTCs in HCC patients, was demonstrated for the first time. The stemness marker EpCAM+ aneuploid circulating tumor stem cells (CTSCs), and EpCAM- small CTCs with trisomy 8, promote tumor growth. Postsurgical quantity of small triploid CTCs (≥5 cells/6 ml blood), multiploid (≥pentasomy 8) CTSCs or CTM (either one ≥ 1) significantly correlated to HCC patients' poor prognosis, indicating that detection of those specific subtypes of CTCs and CTSCs in post-operative patients help predict neoplasm recurrence.
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Affiliation(s)
- Liang Wang
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yilin Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jing Xu
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Aiqun Zhang
- Center for Hepatobiliary Diseases, PLA General Hospital, Beijing, China
| | - Xuedong Wang
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Rui Tang
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xinjing Zhang
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hongfang Yin
- Department of Pathology, Beijing Tsinghua Changgung Hospital (BTCH), Beijing, China
| | - Manting Liu
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China
| | | | | | - Lin Shen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Jiahong Dong
- Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China.
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