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A circulating tumor cell (CTC) is a cancer cell from a primary tumor that has shed into the blood of the circulatory system, or the lymph of the lymphatic system. [1] CTCs are carried around the body to other organs where they may leave the circulation and become the seeds for the subsequent growth of secondary tumors .
If the alterations match, the secondary tumor can be identified as metastatic; whereas if the alterations differ, the secondary tumor can be identified as a distinct primary tumor. [21] For example, people with tumors have high levels of circulating tumor DNA (ctDNA) due to tumor cells that have gone through apoptosis. [22]
Tumor cells found in the bone marrow are known as disseminated tumor cells (DTCs), and those found in the peripheral blood are known as circulating tumor cells (CTCs). These cells have successfully left the primary tumor microenvironment and the SNLs, and are able to survive in a non-native environment, which makes them more aggressive. [3]
After exiting the main tumor, cancer cells circulate throughout the body. They are known as circulating tumor cells once they are in the blood. Few circulating tumor cells can disseminate to distant locations and remain tumor cells. The amount of disseminated tumor cells that can develop into metastases is even lower. [3]
The tumor microenvironment, composed of stromal cells, immune cells and singaling molecules, supports invasion by creating good and favorable conditions for tumor cell migration. [20] For example, cancer- associated fibroblasts (CAFS) produce substances that remodel the ECM and promote cancer progression. [20]
It is theorized that metastasis always coincides with a primary cancer, and, as such, is a tumor that started from a cancer cell or cells in another part of the body. However, over 10% of patients presenting to oncology units will have metastases without a primary tumor found.
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Examples of tumoral markers used to follow up cancer treatment are the Carcinoembryonic Antigen (CEA) for colorectal cancer and the Prostate Specific Antigen (PSA) for prostate cancer. [34] In 2014, Cancer research identified Circulating Tumor Cells (CTCs) and Circulating Tumor DNA (ctDNA) as metastasizing tumor biomarkers with special cellular ...
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