Table 2.
Technologies for CTC detection and their application in human cancers (Label-dependent)
| Technologies | Isolation and enrichment |
Identification and characterization |
Specification and performance |
Limitations | Merits | Cancer type | Ref. |
|---|---|---|---|---|---|---|---|
| -CellSearch® system | -Positive selection; -EpCAM-coated ferrofluid nanoparticles for positive selection of CTCs |
-The captured cells are confirmed by IF stained with CK 8, 18,19 but an absence of CD45 | -Sensitivity: 27%, 32%, 70%; -Specificity: 89%, 99.7%, 93%; -Recovery: 80% |
-Miss EMT-CTCs due to EpCAM dependent | -First FDA approved, -Most clinical validated capture technique |
-Breast, -Colorectal, -Prostate |
52, 154 |
| -AdnaTest® | -Positive selection; -Using a cocktail of antibodies to enhance the enrichment |
-Tested by multiplex RT-PCR for various gene panels (e.g., prostate: KLK3, PSMA, and EGFR; breast: MUC-1, Her2) | -Sensitivity: 73%; -Positive rate: 40% (88 of 221) |
-Contamination with WBCs | -High sensitivity; -Can analyzes bone marrow sample |
-Breast, -Colon, -Ovarian, -Prostate |
51, 52, 155, 156 |
| -MagSweeper | -The magnetically-labeled CD133+ cells were purified | -Whole transcriptome analysis with RNA-Seq | -Sensitivity: 100% -9mL/hr -Detect 1-3 CTCs /mL |
-Expensive; -Unable to further analysis due to CTCs being fixed or lysed |
-High purity; -High throughput processing |
-Breast, -Prostate, -Colorectal |
157, 158 |
| MACS system | -Both positive and negative selection; -Immunomagnetic isolation with anti-pan CK antibody |
-Automated analysis after combined anti- CK/CD45/DAPI staining | -Detect rate: 5/17 | -Identifies EpCAM negative cells but not CK negative ones | -High efficiency | -Lung (NSCL), -Breast, -Pancreatic |
159 |
| CTC-iChip | -Both positive and negative selection; -Deterministic lateral displacement, inertial focusing, and magnetophoresis |
-Molecularly characterized by RT-PCR | -Detection limit: <30 CTCs/7.5 mL; -Processes: 8mL/h; -Recovery: 98.6%; -Throughput:1-2 ml/h |
-Low purity (around 8%); -Complicated fabrication; -Potential RBC contamination |
-Combination of biological and physical properties | -Prostate | 160, 161 |
| RosetteSep™ | -Negative selection; -Using tetrameric antibody complexes that recognize WBC and RBC (CD45, CD66b, and glycophorin) |
-Followed by flow cytometry | -Sensitivity: 59%; -Specificity: 87%; -Diagnosis accuracy: 75% |
-Low recovery rate | -Sensitive | -Pancreatic, -Breast, -Colorectal |
53, 162 |
| Cyttel | -Negative selection; - followed by gradient centrifugation |
-Slide smearing; -In situ hybridization |
-Sensitivity: 83.05%; -specificity:100% |
-Lack of standardized clinical protocols | -High detection rate; -Bimodal identification; |
-Lung (NSCLC), -Colorectal |
58, 163 |