About 30%-50% of colorectal cancer patients would develop recurrence and metastasis. At present, there is still a lack of effective evaluation method for recurrence, metastasis and prognosis. In recent years, a great progress about circulating tumor cells (CTC) in diagnosis and treatment of colorectal cancer has been made. The most common CTC detection methods include immunocytochemistry, flow cytometry, PCR, immunomagnetic separation, optical fiber array scanning and CTC chip. Based on present studies, researchers reach the consensus that CTC is clinically valuable in the following aspects: detection of occult metastasis, monitor of disease progress and evaluation of response to treatment. With recent development of clinical specialization, multi-disciplinary treatment (MDT), gene detection and targeted therapy, individualized treatment may greatly improve overall survive and disease-free survival of colorectal cancer patients. However, the methods above depend on tumor tissues that are always impractical to obtain for late stage and non-surgery patients. Moreover, the size of specimen is always small, making gene expression and mutation detection difficult. CTC detection may solve such problems based on molecular biology with high plausibility and repeatability. Therefore, CTC detection can be used as a new diagnosis tool. It is believed that CTC detection will play an important role in early diagnosis, evaluating recurrence, metastasis, making individualized treatment and predicting prognosis.
Colorectal Neoplasms ; diagnosis ; Disease-Free Survival ; Flow Cytometry ; Humans ; Immunomagnetic Separation ; Neoplasm Recurrence, Local ; Neoplastic Cells, Circulating ; Prognosis

Cancer is a prevalent and challenging disease that is difficult to treat.Western medicine recognizes the disruption of the immune and inflammatory microenvironment as a crucial factor in the development and progression of cancer.According to traditional Chinese medicine,cancer falls into the categories of"accumulation"and"abnormal masses".Based on the attributes of cold and heat in the overall and local conditions as well as the characteristic of the struggle between the vital qi and pathogenic factors at different stages of this disease,this article proposes the concept of"body coldness and tumor heat"to describe the pathogenesis of cancer formation and progression.This pathogenesis aligns with the disruption of the immune and inflammatory microenvironment in modern medical oncology.The article suggests a treatment approach that focuses on balancing cold and heat,nourishing and protecting yang qi,warming the kidneys,and strengthening the spleen to address the"coldness of the entire body".This approach also involves promoting qi circulation,eliminating dampness,phlegm,and stasis,and detoxifying and dispersing nodules to address the"heat in the tumor locally".By addressing deficiencies,eliminating pathogenic factors,and promoting circulation to alleviate stagnation,the aim is to restore the balance of yin and yang and improve the complex state of"coldness of the entire body"and"heat in the tumor locally".These interventions can ameliorate the disorder in the microenvironment and enhance clinical efficacy.