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Mini Review - (2022) Volume 10, Issue 10

Recent Developments and the Use of "Real-Time Liquid Biopsy" with Circulating Tumour Cells in Ovarian Cancer

Wilson Steve*
Department of Cancer and Pharmaceutical Studies, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
*Correspondence: Wilson Steve, Department of Cancer and Pharmaceutical Studies, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK, Email:

Received: 29-Sep-2022, Manuscript No. IPACR-22-13107; Editor assigned: 03-Oct-2022, Pre QC No. IPACR-22-13107; Reviewed: 10-Oct-2022, QC No. IPACR-22-13107; Revised: 17-Oct-2022, Manuscript No. IPACR-22-13107; Published: 27-Oct-2022, DOI: 10.36648/2254-6081-10.10-154


An abnormal mass of tissue that forms once cells grow and divide quite ought to they ought to they must} or don't die once they should. Tumors could also be benign (not cancer) or malignant (cancer). Benign tumors could grow however don't unfold into, or invade, near tissues or alternative components of the body. Malignant tumors will unfold into, or invade, near tissues. They will conjointly unfold to alternative components of the body through the blood and liquid body substance systems conjointly known as tumor. Even with the most recent advances in technology, the treatment of gonad cancer remains an enormous challenge as a result of it's usually diagnosed at advanced stage, is at risk of early relapse in spite of aggressive treatment and has an especially poor prognosis. Current growth cells (CTCs) are often used as a non-invasive “real-time liquid biopsy”, that has shown the worth of diagnosing, assessment of prognosis and chemo resistance, and detection of tiny residual tumors on gonad cancer. This critique provides a summary on recent analysis on CTCs in gonad cancer, with special specialize in the clinical application of CTC tests.

Keywords: Circulating tumor cells; Liquid biopsy; Microfluidics Ovarian cancer; Cancer research; Tumor; Gonad cancer


Ovarian cancer (OVCA) was the eighth commonest diagnosed cancer in Taiwanese ladies with 1587 freshly diagnosed cases in 2018. It’s conjointly the eighth commonest explanation for cancer mortality in Taiwanese ladies with 624 deaths in 2018. Even with current advanced diagnostic tools and also the accessibility of medical service in Taiwan, quite 1/2 the cases were diagnosed at advanced stage. The prognosis of OVCA is very poor, with reported survival rate below four-hundredth. Cancer is caused by changes (mutations) to the DNA inside cells. The DNA within a cell is packaged into an outsized range of individual genes, every of that contains a collection of directions telling the cell what functions to perform, likewise as the way to grow and divide. Errors within the directions will cause the cell to prevent its traditional operate and will enable a cell to become cancerous.

The detection and diagnosing of cancers presently depends on imaging studies and tissue diagnostic test. Even the foremost advanced imaging technologies have limitations in detection tiny lesions or marginal residual tumors. Tissue diagnostic test remained the golden customary to create a definitive diagnosing of suspicious tissue. However, it's invasive, and a few lesions could also be in difficult-to-reach location. Also, tissue diagnostic test could facilitate unfold of the growth in cases of OVCA. Therefore, it's essential to spot new prognostic biomarkers to enhance the management of OVCA.

CTCs are growth cells within the peripheral blood of cancer patients that shed from the growth mass and so enter the blood circulation [1,2]. These cells could transform new growth foci beneath applicable microenvironment when re-entering tissues once more from the blood vessels though it remains to be processed concerning the mechanisms that CTCs migrate from the origin growth foci through blood vessels to new foci, these cells could play an especially vital role within the method of growth metastasis, that is that the major explanation for cancer death.

The extreme rarity of CTCs, with associate degree calculable range of 1–10 CTCs per cc of blood in pathological process cancer patients, constitutes a serious obstacle for CTC detection. Therefore, the key issue for CTC tests is the way to with efficiency isolate associate degreed determine CTCs from an abundance of alternative blood cells which might be achieved by exploiting biological or physiological variations between these cells. The CTC take a look at involves many laboratory procedures, together with CTC enrichment, CTC identification and downstream analysis. The procedure of CTC enrichment plays a essential role owing to the rarity of the CTCs. Current CTC platforms involve enrichment technologies supported a minimum of one physical and/or biological properties of CTCs when enrichment, technique or reverse-transcription PCR (RT-PCR) is then performed to spot the CTCs. The techniques involving downstream single cell analysis have conjointly developed [3].


Biological techniques involving immunoaffinity approach is that the commonest technique for CTC enrichment. The immunoaffinity technique could completely enrich the CTCs by exploitation animal tissue markers or negatively eliminate the blood cells by exploitation organic process markers reported the immunoaffinity technique for CTC enrichment also the system, approved by the office in 2004, that represents the firstgeneration Immunomagnetic-based CTC platform for analytic and enumerating CTCs in pathological process of breast, large intestine or prostate cancers [11]. The Immunomagnetic-based technique uses a force field to separate the CTCs, that ar certain with antibody-magnetic bead complexes, from alternative blood cells.

Immunoaffinity-based microfluidic platform is another life technique for CTC enrichment that is predicated on microfluidic chips with PEG-biotin-streptavidin layer-coated nanostructure [4,5]. The blood sample is pre-treated with biotinylated antibodies, and also the target cells are going to be captured by the PEG-biotin-streptavidin layer on the microfluidic chip by the interaction between PEG-biotin-streptavidin layer on the nanostructure and also the biotinylated protein on the microvilli of CTCs once the mixed cell suspension flows over the chip.

Epithelial cell adhesion molecule (EpCAM) may be a cancerrelated matter that is typically overexpressed in cancer cells derived from animal tissue tissues. Anti-EpCAM protein is so used as a serious capture protein to completely enrich CTCs in several immunoaffinity-based CTC techniques. However, the epithelial– mesenchymal transition (EMT) throughout the method of cancer metastasis could down regulate the EpCAM expression and also the EpCAM expression of cancer cells could chance variable in numerous cancer sort or subtype. EMT is a necessary method of cancer metastasis. The cancer cells lose their cell polarity and cell–cell adhesion to become mesenchymal stem cells and gain migratory and invasive properties. The variation in EpCAM expression of cancer cells could greatly have an effect on the capture potency of the immunoaffinity-based CTC platform. within the example of animal tissue gonad cancer (EOC), the general rate of EpCAM overexpression is seventy three, whereas liquid body substance glandular carcinoma of ovary has associate degree EpCAM overexpression rate of as low as fifty fifth [6,8]. Some studies discovered that the mixture of animal tissue and mesenchymal antibodies will markedly increase the capture rate to beat the impact of low EpCAM overexpression of CTCs on the capture rate by exploitation single anti-EpCAM protein.

In the past few decades, several techniques are developed to counterpoint and determine CTCs and microfluidics connected CTC platforms could develop the quickest among these technologies. However, of these CTC platforms haven't nevertheless been wide utilized in clinical apply. At present, most of the CTC techniques still think about a lot of work force operation, leading to unstable take a look at results and inability to conduct larger range of tests. Therefore, the automation of the CTC laboratory method has become a key challenge. Some machine-controlled systems have recently been developed for CTC detection. Aguilar-Avelar et al. designed high-throughput machine-controlled research of CTCs to operate-free and sturdy analysis of CTCs conjointly incontestable an automatic immunoaffinity-based CTC platform that may effectively capture SKBR3 carcinoma cell lines and are used for non-invasive foetal diagnosing.

Another vital issue of cancer management is to work out whether or not more treatment is needed when best growth debulking. The present decision-making for added adjuvant general treatment is typically supported the cancer staging and alternative risk factors. However, the shortage of a reliable biomarker to notice electronic dictionary or micro-metastasis sometimes makes the decisionmaking troublesome and will cause under- or over-treatment of the malady. The detection and elimination of electronic dictionary in patients with EOC remains one in every of the most challenges in gynecological medical specialty. CTCs take a look at is meant to own the potential of a sensitive and specific marker to notice electronic dictionary that can't be detected by current biomarkers or the foremost advanced imaging modalities have incontestable that the detection of CTCs in optimally debulked OVCA patients by the multi-marker super molecule panel and/or MECOM/ HHLA1 FISH had a considerably shorter OS, that represents the existence of electronic dictionary or micro-metastasis conjointly reported that patients with electronic dictionary when primary cytoreduction surgery had the next incidence to own detectable EMT-like CTCs.

Recent studies have discovered that CTC tests, together with CTC enumeration and molecular characterization, could offer non-invasive different biomarker for clinical medical care stratification and as a “real time liquid biopsy”, which might be useful in each step of the management pf cancer patients from diagnosing, assessment of prognosis, analysis of therapeutic result, to the prediction of treatment resistance and detection of electronic dictionary. Advances in single cell analysis, together with identification of genetic science and genomic aberrations of the CTCs, facilitate America learn additional concerning the mechanisms of cancer metastasis, treatment resistance and cancer evolution. Advances of automation of CTC platform and high-efficiency microfluidic chips have more and more incontestable the likelihood of clinical application of the CTC tests [9,10].


Several studies have exploited the connection between CTC counts and also the progression of malady. moreover, the studies on CTCs have step by step progressed from enumeration of CTCs to careful molecular analyses of the cells and also their use as a “real time liquid biopsy” to watch the progress and the prognosis of the malady likewise because the evolution of the growth cells. The one cell analysis of CTCs permits America to induce insights into the molecular characteristics and growth evolution of the malady and to induce additional info for decision-making of the management. The physical techniques are supported variations of physical properties between CTCs and non-malignant blood cells, together with the cell sizes, densities, electrical charges and deformability. Recently, several studies have developed involving the microfluidic-based physical techniques of microfiltration, fluid mechanics or dielectrophoresis for CTC enrichment Even with the promising results of the many previous studies, the present clinical tips for OVCA still don't support the routine application of CTC tests. Additional clinical validation remains required before the liberal use of CTC tests. However, CTC tests could add extra clinical info, especially the cell markers for treatment resistance or therapeutic targets, that aren’t accessible by current diagnostic technologies, and it'll show a bright future for personalized medication.


I would like to thank my professor for his support and encouragement.

Conflict of Interest

The authors declare that there is no conflict of interest.


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Citation: Steve W (2021) Recent Developments and the Use of "Real-Time Liquid Biopsy" with Circulating Tumour Cells in Ovarian Cancer. Archives Can Res, Vol.10 No. 10: 154.