title: Feasibility of a novel one-stop ISET device to capture CTCs and its clinical application.
abstract: BACKGROUND
  Circulating tumor cells (CTCs) play a crucial role in cancer metastasis. In this study, we introduced a novel isolation method by size of epithelial tumor cells (ISET) device with automatic isolation and staining procedure, named one-stop ISET (osISET) and validated its feasibility to capture CTCs from cancer patients. Moreover, we aim to investigate the correlation between clinicopathologic features and CTCs in colorectal cancer (CRC) in order to explore its clinical application.
  
  
  RESULTS
  The capture efficiency ranged from 80.3% to 88% with tumor cells spiked into medium while 67% to 78.3% with tumor cells spiked into healthy donors' blood. In detection blood samples of 72 CRC patients, CTCs and clusters of circulating tumor cells (CTC-clusters) were detected with a positive rate of 52.8% (38/72) and 18.1% (13/72) respectively. Moreover, CTC positive rate was associated with factors of lymphatic or venous invasion, tumor depth, lymph node metastasis and TNM stage in CRC patients (p < 0.01). Lymphocyte count and neutrophil to lymphocyte ratio (NLR) were significantly different between CTC positive and negative groups (p < 0.01).
  
  
  METHODS
  The capture efficiency of the device was tested by spiking cancer cells (MCF-7, A549, SW480, Hela) into medium or blood samples of healthy donors. Blood samples of 72 CRC patients were detected by osISET device. The clinicopathologic characteristics of 72 CRC patients were collected and the association with CTC positive rate or CTC count were analyzed.
  
  
  CONCLUSIONS
  Our osISET device was feasible to capture and identify CTCs and CTC-clusters from cancer patients. In addition, our device holds a potential for application in cancer management.
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Shuyi
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Department of Circulating Tumor Cells, YZY Medical Technological Company, Wuhan, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhi
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Boran
authors.initials: B
authors.lastname: Cheng
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Dongdong
authors.initials: D
authors.lastname: Shi
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Haibin
authors.initials: H
authors.lastname: Song
authors.affiliation: Department of Circulating Tumor Cells, YZY Medical Technological Company, Wuhan, China.
authors.forename: Congli
authors.initials: C
authors.lastname: Cai
authors.affiliation: Department of Circulating Tumor Cells, YZY Medical Technological Company, Wuhan, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xiong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002452:Cell Count; D045744:Cell Line, Tumor; D002469:Cell Separation / Q000295:instrumentation / Q000379:methods; D055088:Early Detection of Cancer / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis*; D009360:Neoplastic Cells, Circulating / Q000378:metabolism* / Q000473:pathology*; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000295:instrumentation / Q000379:methods
keywords: circulating tumor cells (CTCs); clusters of circulating tumor cells (CTC-clusters); colorectal cancer (CRC); epithelial-mesenchymal transition (EMT); isolation method by size of epithelial tumor cells (ISET)