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Table 3 Clinical Application value of CTCs in CRC

From: Detection and clinical significance of circulating tumor cells in colorectal cancer

Patient number Technique Marker CTC cut-off Patient ratio (%) Significance Ref
10 ClearCell FX
Differences in the metabolic profile can be used to discriminate CTCs andlymphocytes obtained from the same patient and CTCs of different cancer types. [93]
50 RT-PCR 82.00 The CTCs number obtained by quantifying mRNAs of six CRC-related genes (CEA,EpCAM, CK19, MUC1, EGFR and C-Met) in the blood was associated with 2-year PFS. [94]
132 CellSearch EpCAM ≥3CTC/7.5 ml 19.00 Baseline and 4 weeks CTCs counts ≥3/7.5 mL in CRC patients with potentiallyresectable liver metastases were associated with decreased OS. [95]
44 CellSearch EpCAM ≥2CTC/7.5 ml 18.6 Preoperative CTCs counts ≥2/7.5 mL in CRC patients with resected liver metastaseswere associated with decreased DFS and OS. [97]
130 MACS CD45 ≥2CTC/3.2 ml 51.54 Postoperative CTCs counts ≥2/3.2 mL in non-mCRC was associated with decreased RFS. [99]
66 CanPatrol
Multiplex mRNA-ISH
≥6CTC/5 ml 86.4 CTCs counts ≥6/5 ml was associated with decreased PFS and OS. LGR5 expressionin CTCs may serve as a marker for CRC metastasis. [100]
Akt-2 (≥0.25 ng μl-1) expression in CTCs was associated decreased median PFS. [103]
91 CanPatrol
≥3CTC/5 ml
≥1mCTC/5 ml
CTC 56.0
mCTC 50.5
Mesenchymal CTC counts ≥1/5 ml and COX-2 expression in mCTCs were associatedwith distance metastasis. [104]
42 CellSearch EpCAM ≥3CTC/7.5 ml 52.3 Patients with CTC ≥3/7.5 ml may benefit from the intensive 4-drug regimen (irinotecan,oxaliplatin, and tegafur-uracil with leucovorin and cetuximab). [106]
Flow Cytometry
> 30CTC/ml 52.7 CTCs counts > 30/ml in mCRC patients treated with chemotherapy was associatedwith decreased PFS and OS. [107]
138 ISET device-CTCBIOPSY ≥1CTC/2.5 ml 45.7 Post curative resection CTCs counts > 1/2.5 ml was associated shorter 3-year RFS rate. [108]
589 CellSearch EpCAM ≥3CTC/7.5 ml 41 Baseline CTCs counts ≥3/7.5 mL was associated with clinical or pathologic featuresassociated with poor Prognosis. [110]
628 qRT-PCR 33.6 Plastin3 is a CTC marker specifically expressed in metastatic colorectal cancer cells.Preoperative PLS3-positive CTCs in peripheral blood were associated decreased DFSand OS. [112]
60 The CTCs captured by the ISET system allows for counting, genotypic and phenotypiccharacterization. Using a qPCR method, KRAS exon 2 mutations were successfullydetected in CTCs of patients with RAS-WT mCRC who treated with first-linechemotherapy and monoclonal antibodies. [116]
61 CellSearch
ASONE Cell PickingSystem
EpCAM ≥1CTC/7.5 ml 44.3 CTC heterozygosity and heterogeneity exist in KRAS status among CTCs within apatient and between CTCs and tumor tissues. [117]
50 CellSearch
EpCAM ≥3CTC/7.5 ml 46 CTCs counts ≥3/7.5 mL at baseline and day 21 after initiation of regorafenib wereassociated decreased PFS and OS. Patients had significantly increased EGFR expressionat day 21 and/or PD compared to baseline. [118]
EpCAM Patients with higher gene panel expression (composed of GAPDH, VIL1, CLU, TIMP1,TLN1, LOXL3 and ZEB2) at baseline or increased gene panel expression duringtreatment had decreased PFS and OS. This CTC detection panel had increasedreliability compared to computed tomography scan. [132]
106 MACS
≥5CTC/ml 100 HAI/target therapy with drugs selected by liquid biopsy precision oncotherapy isa safe and efficacious alternative therapeutic strategy for unresectable colorectalliver metastases patients. [133]