1, assisting clinical diagnosis and staging.
It is found that in some patients with early tumors, CTCs can be detected in peripheral blood before imaging findings, so CTCs can be used for early diagnosis of tumors. In 2007, ASCO listed CTC as a tumor marker. Blood system is an important way of tumor metastasis, and whether distant metastasis occurs is one of the criteria for judging clinical staging. In recent years, the clinical application of CTCs detection makes it an effective supplement to the traditional TNM staging system, thus guiding the next treatment.
2. Prognostic evaluation
At present, it has been confirmed that CTCs detected in blood can be used as an independent prognostic factor for breast cancer, prostate cancer and colon cancer. The more CTC, the worse the prognosis. Before the patients with metastatic breast cancer received systematic treatment, the CTC count in every 7.5 ml of blood exceeded 5, which indicated that the progression-free survival and overall survival were short. In patients with metastatic colon cancer, the CTC count per 7.5 ml of blood exceeds 3, and the median overall survival and progression-free survival of patients are significantly shortened. Compared with traditional imaging methods, CTC counting can reflect the disease state earlier and predict the prognosis of patients, and can predict the overall survival of patients more accurately.
3. Efficacy monitoring
At present, there are more and more ways to treat tumors, so it is particularly important to evaluate the therapeutic effect of patients. The research shows that the change of CTC amount before and after treatment has a good corresponding relationship with the standard curative effect evaluation system. In the process of tumor treatment, the effect of tumor treatment can be evaluated more accurately by dynamically monitoring the change of CTC quantity.
4. Establish CDX mouse model (CTC-derived xenograft).
Usually, the establishment of human tumor mouse model (PDX) requires the surgical specimens of tumor patients, and the patients need surgical specimens or puncture specimens, which is very painful and will also cause trauma to patients. CTCs make it possible to cultivate enriched cancer cells in vitro and transplant living tumor cells into mice to establish individualized tumor animal models.
Shanghai Li Di Biotechnology Co., Ltd. is an enterprise that provides one-stop personalized precision treatment solutions for cancer patients. It is understood that Li Di has successfully conducted many such experiments. One of the patients with intestinal cancer had an operation in a well-known hospital, and the result was negative by using the existing CTC instrument in the market. By chance, Shanghai Liwen Medical Laboratory tested CTC, and the results were not only positive, but also rich in integrated tumor cell clusters, equivalent to tumor stem cells, and its metastasis rate was 20-30 times higher than that of ordinary tumor cells. This means that the cancer cells in the patient's body are likely to have metastasized, and the success rate of establishing an individualized tumor animal model with mice transplanted with tumor cell clusters is higher.
5, individualized treatment
As a kind of "liquid biopsy", CTCs make up for the shortage of obtaining tumor tissue in clinic. Clinical experts can enrich and isolate CTC from peripheral blood, even culture CTC in vitro, analyze the molecular epigenetic characteristics of CTC, carry out a series of genetic tests on CTC, screen out chemotherapy and molecular targeted drugs suitable for patients, and further guide individualized treatment.
Conclusion: With the deepening of our research on CTCs, CTCs will also help us to understand more clearly the molecular mechanism of tumor occurrence, recurrence and metastasis, as well as the role of tumor stem cells in EMT, tumor metastasis and drug resistance, which is also of great significance for guiding the development of anti-tumor drugs. It is believed that in the near future, CTCs will definitely become a commonly used detection index in tumor treatment, guiding patients to implement individualized treatment.