Theranostics 2013; 3(6):377-394. doi:10.7150/thno.5195


Detecting Circulating Tumor Cells: Current Challenges and New Trends

Bin Hong1, Youli Zu2✉

1. TeloVISION, LLC, 1281 Win Hentschel Blvd. West Lafayette, IN 47906, USA;
2. Department of Pathology and Genomic Medicine, The Methodist Hospital, 6565 Fannin, MS205, Houston, TX 77030, USA.

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Hong B, Zu Y. Detecting Circulating Tumor Cells: Current Challenges and New Trends. Theranostics 2013; 3(6):377-394. doi:10.7150/thno.5195. Available from

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Circulating tumor cells (CTCs) in the blood stream play a critical role in establishing metastases. The clinical value of CTCs as a biomarker for early cancer detection, diagnosis, prognosis, prediction, stratification, and pharmacodynamics have been widely explored in recent years. However, the clinical utility of current CTC tests is limited mainly due to methodological constraints. In this review, the pros and cons of the reported CTC assays are comprehensively discussed. In addition, the potential of tumor cell-derived materials as new targets for CTC detection, including circulating tumor microemboli, cell fragments, and circulating DNA, is evaluated. Finally, emerging approaches for CTC detection, including telomerase-based or aptamer-based assays and cell functional analysis, are also assessed. Expectantly, a thorough review of the current knowledge and technology of CTC detection will assist the scientific community in the development of more efficient CTC assay systems.

Keywords: CTC: Circulating tumor cell, CTM: Circulating tumor microemboli, CTMat: Circulating tumor materials, CTDNA: Circulating tumor DNA, POCT: Point-of-care test.