Capture and characterization of disseminated tumor cells in bone marrow, blood, and lymph nodes of patients with cancer: Progress and challenges

The prognostic importance of the presence of disseminated tumor cells (DTC), which spread to lymph nodes (lymphatic dissemination) and/or bone marrow (systemic or hematogenous dissemination), has been documented in a variety of cancer types. Because the detection of disseminated tumor cells by bone marrow aspiration involves an invasive procedure, a technique that could reliably detect systemic tumor cell dissemination as circulating tumor cells (CTC) in the peripheral blood would be of great advantage over one in which a sample of bone marrow is required. Unfortunately, the yield of circulating tumor cells is comparatively lower than in bone marrow. One of the reasons for the decreased rate of detection of circulating tumor cells in blood could be the limitation of the current methodologies, which are suboptimal in capturing circulating tumor cells from blood. Therefore, it is necessary to develop new technologies to facilitate the integration of circulating tumor cells detection into clinical patient treatment.