title: Biology and significance of circulating and disseminated tumour cells in colorectal cancer.
abstract: OBJECTIVE
  More than 130 years ago, circulating tumour cells (CTCs) and disseminated tumour cells (DTCs) have been linked to metastasis. Since then, a myriad of studies attempted to characterise and elucidate the clinical impact of CTCs/DTCs, amongst others in colorectal cancer (CRC). Due to a flood of heterogeneous findings regarding CTCs/DTCs in CRC, this review aims to describe the known facts about CTC/DTC biology and clinical impact.
  
  
  METHODS
  To identify the basic scientific literature regarding the biology and clinical impact of CTCs/DTCs in CRC, we reviewed the literature in the PubMed database. We focused on publications written in English and published until January 2012. As search terms, we used "colorectal cancer (CRC)", "colon cancer (CC)", "CTC", "DTC", "bone marrow (BM)", "lymph node (LN)", "peripheral blood (PB)", "significance" and "prognosis".
  
  
  RESULTS
  CTC detection and quantification under standardised conditions is feasible. Several studies in large patient settings have revealed prognostic impact of CTCs in CRC. CRC-derived DTC detection and analysis in BM exhibits a more heterogeneous picture but also shows clinical value. Furthermore, the presence of DTCs in LN has a strong prognostic impact in CRC.
  
  
  CONCLUSIONS
  Clinical relevance and prognostic significance of CTCs/DTCs in CRC have been clearly demonstrated in many experimental studies. The major challenge in CTC/DTC research is now to harmonise the various identification and detection approaches and consequently to conduct large prospective multi-institutional trials to verify the use of CTCs/DTCs as a valid prognostic and predictive biomarker for clinical routine.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steinert
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schölch
authors.forename: Moritz
authors.initials: M
authors.lastname: Koch
authors.forename: Jürgen
authors.initials: J
authors.lastname: Weitz
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics; D019046:Bone Marrow Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000556:secondary; D049109:Cell Proliferation; D015179:Colorectal Neoplasms / Q000235:genetics / Q000473:pathology / Q000503:physiopathology*; D004195:Disease Models, Animal; D018450:Disease Progression; D058750:Epithelial-Mesenchymal Transition / Q000502:physiology; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000556:secondary; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D051379:Mice; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000503:physiopathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor