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blood sample is subjected to filtration through polycarbonate
membranes presenting 8 μm pores, we can separate the CTCs.
Figure 2 outlines an overview of CTC enrichment, detection, and
downstream applications.Previous studies have confirmed a high frequency of CTCs in
esophageal adenocarcinomas when compared to esophageal squa-
mous cell carcinoma. These diverse CTC detection rates indicate
the potential difference in the clinical/molecular pathogenesis
between these two histological types of esophageal carcinomas. The
only Food and Drug Administration (FDA) of USA approved CTC
detection method in clinics is the CELLSEARCH® system.
However, there are limitations in detecting weak EpCAM and
CK-positive CTC cells. A combination of markers or detection
strategies is also required to identify EpCAM negative cells that will
in turn improve the quality of results in CTC detection. The other
methods for the detection of CTCs include Epic sciences, Maintrac,
ISET tests, filter-based (capture CTC by size) and biological tech-
niques based on antigen- antibody bindings. This chapter will detail
the methods from CELLSEARCH® CTC detection system.1.5 Esophageal
Adenocarcinoma
and Challenges
in the Detection of CTC
Fig. 2 CTC workflow. Different methods in CTC detection and downstream molecular, cellular, and in vivo
applications
Vinod Gopalan and Alfred K. Lam