Open Access

ARTICLE

Circulating tumor cells: Biological features and survival mechanisms

XIAOFENG LI¹, JINYANG ZHENG², JINFENG ZHU³, XIN HUANG⁴, HUANHUAN ZHU⁵, BINGDI CHEN^6,*

1 Department of Oncology, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, China
2 Department of Pathology, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, China
3 Department of Medical Oncology, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, China
4 Department of Dermatology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
5 Department of Central Laboratory, Shanghai Tenth People’s Hospital, Shanghai, China
6 Shanghai East Hospital, The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, China

* Corresponding Author: Bingdi Chen,

(This article belongs to the Special Issue: Expert Opinions and Future Trends on Stem Cells, Biomaterials and Growth Factors)

BIOCELL 2023, 47(8), 1771-1781. https://doi.org/10.32604/biocell.2023.028343

Received 13 December 2022; Accepted 06 February 2023; Issue published 28 August 2023

Abstract

Circulating tumor cells (CTCs) are neoplastic cells that are detached from primary tumors and enter circulation. Enumeration and characterization of CTCs are of significance in cancer diagnosis, prognosis, and treatment monitoring. CTC survival in the bloodstream is a limiting step for the development of metastases in distant organs. Recent technological advances, especially in single-cell molecular analyses have uncovered heterogeneous CTC survival mechanisms. Undergoing epithelial-to-mesenchymal transition (EMT), increasing stem cell-like properties, and forming cell clusters enable CTCs to adapt to the harsh microenvironment of the circulation. Expressing and releasing several immunosuppressive molecules help CTCs escape from anti-cancer immune mechanisms. This review article summarizes the biological characteristics of CTCs and focuses on the recent understanding of the mechanisms by which CTCs survive in circulation. Additionally, the clinical and therapeutic implications of CTCs are discussed.

---

Keywords

---