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Circulating Tumor Cells: From Fiction to Reality

Chiara Nicolazzo1, Federica Francescangeli2, Flavia Loreni1, Nicole Caputo1, Luciano Colangelo3, Chiara Sonato3, Giada della Grotta3 and Walter Gianni3*
1Department of Molecular Medicine, Sapienza University of Rome, Italy
2Department of Hematology, Istituto Superiore di Sanità, Italy
3Department of Internal Medicine and Geriatrics, Policlinico Umberto I, II, Sapienza University of Rome, Italy

*Corresponding author: Walter Gianni, Department of Internal Medicine and Geriatrics, Policlinico Umberto I, II, Sapienza University of Rome, Viale del Policlinico 155, Rome, 00161, Italy

Published: 09 Jun, 2018
Cite this article as: Nicolazzo C, Francescangeli F, Loreni F, Caputo N, Colangelo L, Sonato C, et al. Circulating Tumor Cells: From Fiction to Reality. Clin Oncol. 2018; 3: 1475.

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Described for the first time by Ashworth in 1869 [1], circulating tumor cells are considered silent predictors of metastasis [2]. Indeed, their generation is a fundamental prerequisite to the tumors metastatic process [3], making them a non-invasive appealing tool for precision medicine.
Although a flawless method has not yet been identified, the countless technological efforts to detect isolate and characterize CTCs [4], make them suitable for clinical applications and promising for future translational uses.
To date, though the predictive significance of CTCs is still under debate [5], robust data demonstrate that such cells have an undoubted prognostic value in patients with solid tumors, such as breast [6], colorectal [7], prostate [8] and gastric cancers [9]. Furthermore, the possibility to find CTCs even in non-metastatic [10] as well as rare tumors, such as sarcoma [11,12] or hemangiopericytoma [13], opens new horizons toward a best understanding of disease biology in order “to fight the enemy with the right weapons”.


The authors would like to thank Dr. Ann Zeuner for her expert technical assistance.

Financial Support

This work was supported by A.R.Ger.On. Onlus.

Figure 1

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Figure 1
Images of Circulating Tumor Cells (CTCs). A puppet CTC under a microscope (A): Triple immunofluorescence staining on real CTCs isolated from a metastatic colorectal cancer patient. CK 20: cytokeratin 20; EpEX: EpCAM extracellular domain; EpICD: EpCAM intracellular domain; DAPI: 4', 6-Diamidine- 2'-phenylindole; EpCAM: epithelial cell adhesion molecule (B).


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