Isolation and Enumeration of CTC in Colorectal Cancer Patients: Introduction of a Novel Cell Imaging Approach and Comparison to Cellular and Molecular Detection Techniques

Despite significant progress in screening and treatment regimens, colorectal cancer (CRC) still is a major health burden lacking profound liquid biomarkers for identifying patients at risk. Circulating tumour cells (CTC) have the potential to non-invasively improve the diagnosis. We have already established a sensitive semi-quantitative RT-qPCR against CK20 for CTC quantification in CRC patients. For clinical translation, this study aims to validate our molecular detection method by terms of cytological approaches, and implement a novel semi-automated microscopic detection after immunofluorescence labelling of CTC. Additionally, we aim to compare our PCR-based approach to a marker-independent, but size-dependent, enrichment process. We have successfully applied the validation techniques and proved their feasibility. Enumeration by size yielded the highest numbers of CTC and demonstrated to be the most reliable strategy for CTC detection in CRC patients. Future studies with larger patient cohorts will have to investigate the clinical significance and prognostic value of this approach.