Optimization and clinical validation of ISET-ICC technical system for de-tection of circulating tumor cells
10.3969/j.issn.1009-9905.2025.01.003
- VernacularTitle:ISET联合循环肿瘤细胞免疫荧光技术的优化及临床验证
- Author:
Zhi-kun ZHAO
1
;
Ying MA
;
Pang LI
;
Sheng LI
;
Zhen-dan WANG
Author Information
1. 山东第一医科大学第二附属医院 普外科(山东 泰安 271016);山东省医学科学院(山东省药物研究院)(山东 济南 250062)
- Publication Type:Journal Article
- Keywords:
Circulating tumor cells;
Membrane filtration separation of tumor cells;
Cell immunofluorescence tech-nique
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(1):12-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To optimize the previously established Improved Membrane Filtration(ISET)method for de-tecting circulating tumor cells(CTCs)and to develop and validate a new,reliable CTC detection method by combining it with immunofluorescence techniques.Methods:The study involved optimizing the CTC detection system using mixed samples of gastric cancer 803 cell lines and peripheral blood(PB)from healthy volunteers to simulate the peripheral blood of cancer patients.The optimized system was validated using peripheral blood samples from 23 patients with ad-vanced(Ⅲ/Ⅳ)cancer,employing the ISET technique combined with immunocytochemistry(ICC)and paraffin block im-munohistochemistry(IHC)identification techniques.A cohort of 74 patients with various cancer types was used to com-pare the diagnostic performance of the membrane filtration combined with immunofluorescence(ISET-ICC)system against the CTC-Biopsy and CellSearchTM methods.Results:By adding a red blood cell lysis step and increasing the membrane pore size to 10 μm,the filtration time of the ISET method was reduced by threefold.The ISET-ICC detection method achieved a CTC positivity rate of 65.2%.The combination of the ISET-ICC system with the cell paraffin block-IHC method enhanced the reliability of identifying circulating tumor cells undergoing epithelial-mesenchymal transition(EMT-CTCs).The ISET-ICC technique demonstrated a significantly higher CTC positivity rate(17.6%;13/74)within the study cohort compared to the CellSearchTM method,which showed a CTC positivity rate of 12.2%(9/74;x2=10.21,P=0.007).The difference in positive detection rates among patients at different stages was statistically significant(x2=3.64,P=0.029),with a notably higher CTC detection rate in stage Ⅳ patients compared to those in stages Ⅰ-Ⅲ(x2=6.76,P=0.001).Conclusion:The improved ISET-ICC system effectively detects CTCs across various cancer types and dem-onstrates greater accuracy compared to the CellSearchTM system.