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Detection of circulating tumor cells in non-small cell lung cancer.

Lollinga, W.T. (2010) Detection of circulating tumor cells in non-small cell lung cancer. Bachelor's Thesis, Biology.

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In recent years, new insights into cancer organization have changed its definition from a single- towards a multi-organ disease. It is nowadays characterized by a primary tumor site with secondary spread to distant organs. The treatment for NSCLC in specific, which is a prominent cause of cancer-related deaths, consists of surgical resection of the tumor. However, patients who are cleared from the primary cancer are not guaranteed to stay cancer-free for life and distant organ metastasis and minimal residual disease comprise serious threats. The identification and characterization of circulating tumor cells (CTCs) could play an important role for diagnostic and treatment purposes. CTCs are shed from either the primary tumor or its metastases and can be detected in the peripheral blood. Identification of CTCs in blood samples provides a low invasive technique compared to the obtainment of biopsies, which is nowadays the common way to detect tumors in combination with microscopic techniques and scans. Identification is based on EpCAM+, cytokeratin+, CD45- and presence of a DAPI+ nucleus. Here an overview is given of methods and studies in which CTCs have been detected in NSCLC patients. With that the implications of CTC detection for diagnostic and therapeutic purposes are discussed. A number of methods to detect and characterize CTCs are being explored but only one method is currently validated and approved for use in clinical studies. This CellSearch (Veridex) platform uses an epithelial marker to enrich tumor cells from epithelial origin, followed by detection and enumeration using immunohistochemistry. Different studies show that CK19+-cells are differently present before, during and after treatment and the relation between CK19+-cells and several parameters related to survival. It turned out that the CTCs present in the bloodstream were similar to the primary tumor cells present relatively late in the course of the metastasis. Detection rates however largely differ (from several to thousands of CTC) between detection techniques and control groups vary in different studies, which makes solid conclusions difficult. CTCs could be used as reliable diagnostic and prognostic tool (maybe for screening) in the future, but for now it should be combined with conventional methods to achieve maximal effect.

Item Type: Thesis (Bachelor's Thesis)
Degree programme: Biology
Thesis type: Bachelor's Thesis
Language: English
Date Deposited: 15 Feb 2018 07:31
Last Modified: 15 Feb 2018 07:31

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