According to current studies, CTC is recognized as prognostic factor for lots of cancers, including breast cancer, prostate cancer, bowel cancer and more. The higher number of CTC in blood indicates poor prognosis of patients. Comparing with conventional radiological examination, CTC counting affords much more prior cancer screening and auxiliary diagnosis, and provides more authentic total survival time of patients.
The number of CTC >5 demonstrated lower survival rate than the number of CTC <5 in 7.5mL peripheral blood from breast cancer patients and bowel cancer patients respectively.
CTC tumor classification :
“Epithelial-Mesenchymal transition” means the process of CTC inter-conversion between cancer-cell states involving epithelial, mesenchymal and epithelial-mesenchymal when it enters the blood circulating system. It is important to note that mesenchymal CTCs have higher possibilities of migration.
To classify CTC tumor and accelerate tumor determination, CELLOMICS CTC100 cell sorter makes the isolated CTCs perfectly suitable for further downstream analysis. The sorted cancer cells can be visualized by immunostaining; the fluorescent-tagged immuno-protein can specifically bind to epithelial biomarker EpCam or mesenchymal biomarker Cell Surface Vimentin (CSV) on cancer cells and reflect light to anticipate the cell membrane of CTC.
CTC with EpCam expression show more clear cancer progression
Other than tumor classification, CELLOMICS CTC100 cell sorter and immunostaining can also be applied on CTC target protein expression detection (such as PD-L1 expression and etc.), which provides useful information for medical treatment selection and dynamic monitoring and etc.
PD-1/PD-1 immunotherapy is the most prevalent anti-cancer therapy nowadays. It aims at triggering natural immune responses to defense cancer. Despite years of clinical verification, it does not applicable to all cancer patients. Consequently, it raises the necessity to deal with the problem of sensitive people determination. According to studies, highly expressed PD-L1 in CTC patients may have higher chance to be benefit from PD-1 immunotherapy.
- PD-L1 sensitive test before treatment to evaluate the fitness of PD-L1 to individuals
- PD-L1 immunotherapy therapeutic effect real time monitoring
Immuno-FISH technique :
CTC that is enriched by CELLOMICS CTC100 Cell Sorter is able to perform Fluorescence in situ hybridization (FISH) technique for DNA mutation detection. The fluorescent-tag-probes hybridize to particular gene location and reveal the position and number of CTC mutation sites, including EML4-ALK, HER2, cMET and etc. CTC immuno-FISH technique contributes to improve current CTC identification by molecular properties and provides more reliable information for CTC classification.
The CTC samples collect from CELLOMICS CTC100 Cell Sorter can be employed in PCR-based gene targeting analysis for instance, droplet digital PCR (ddPCR), quantitative PCR (qPCR) and etc. The detecting genes contain lung cancer or breast cancer mutation genes EGFR, KRAS, TP53, PIK3CA and etc. They are crucially relevant to tumor targeting therapy for treatment guide and real-time monitoring by providing comprehensive and personalized genomic information for patient.
- Detecting EGFR mutation in CTC with ddPCR
NGS and Driver gene detection :
CELLOMICS CTC100 Cell Sorter is also able to sort out CTC for Next Generation Sequencing (NGS) and Single Cell Sequencing. Integrating the whole genome sequencing, exosomal sequencing, targeted gene sequencing, transcriptome sequencing and methylation sequencing, can the CTC molecular mechanism and metastatic mechanism be studied and analyzed thoroughly, and uncovered unknown gene targets.
Through sequencing, it suggested that MET-CTC and EMT-CTC demonstrated enormous differences in MET, EMTHE and CSC-related gene expression.
Cell Culture/PDX :
An intact CTC carries a lot of tumor information, including proteins, DNA mutation, coding DNA, non-coding DNA and etc. In vitro CTC culturing for drug sensitivity test has been proved to be applicable to medication selections, which exhibits foreseeable clinical potentials.
(Consensus among professionals: Liquid Biopsy in clinical tumor treatment applications and practices of medical diagnosis)
- In vitro Breast Cancer CTC multiplication
- The drug sensitivity test has manifested the same results with clinical cases