CÉLULAS TUMORALES CIRCULANTES EN LA PRÁCTICA ONCOLÓGICA: IMPORTANCIA EN TUMORES SÓLIDOS EPITELIALES
Palabras clave:
Células tumorales circulantes (CTC), tumores sólidos y metástasis, Circulating tumor cells (CTC), solid tumor, metastasisResumen
RESUMEN
Las metástasis de los tumores sólidos se producen cuando las células de un carcinoma primario o metastásico migran en el sistema circulatorio y proliferan en lugares distantes. Los carcinomas son de origen epitelial y no es habitual que estas células se encuentren en el torrente circulatorio. En los últimos 20 a 30 años se han utilizado diferentes métodos y tecnologías para la determinación de células tumorales circulantes (CTC) en sangre periférica y médula ósea. Pero estos sistemas de recolección (Cyto-spins, magnetic beads, latex beads, cell-sorting (flow cytometry), density-gradient media, column separation) o de análisis (Immuno-staining, flow cytometry, Imnunohistochemistry, Fluorescence in situ hybridization, nucleic acid probes) presentan inconvenientes en cuanto a que son técnicas manuales y no estandarizadas de interpretación subjetiva, algunas sin validadación, con ausencia de un sistema de análisis específicamente diseñado para laboratorios clínicos RUO “components” y ausencia de evidencia clínica constatada que soporte la adopción del estudio de las CTC por los clínicos.
El sistema de detección CellSearch representa la primera tecnología automatizada y estandarizada que fue aprobada por la FDA para predecir la progresión y la supervivencia libre de enfermedad en el cáncer de mama metastásico. La presencia de células tumorales circulantes (CTC) en sangre periférica detectadas con CellSearch® circulating Tumor Cell System, está asociada a menor supervivencia libre de enfermedad (SLE) y menor supervivencia global (SG) en pacientes de cáncer de mama, colorrectal y de próstata metastatizante.
Palabras clave: Células tumorales circulantes (CTC), tumores sólidos y metástasis.
ABSTRACT
CIRCULATING TUMOR CELLS IN ONCOLOGIC PRACTICE: ROLE IN EPITHELIAL SOLID TUMORS
Metastasis of solid tumors occurs when cells in a primary or metastatic carcinoma migrate through the circulation and proliferate at distant sites. Carcinomas are of epithelial origin and their cells are seldom seen in the bloodstream. In last decades, different methods and technologies for the identification of circulating tumor cells (CTC) in peripheral blood and bone marrow have been used. But collection systems (Cyto-spins, magnetic beads, latex beads, cell-sorting -flow cytometry- density-gradient media, column separation) or testing (Immunestaining, flow cytometry, Immunohistochemistry, Fluorescence in situ hybridization, nucleic acid probes) have drawbacks; they have no standardized manual and subjective interpretation, some are not validated, no analysis system have been specifically designed for clinical laboratory RUO “components” and no proven clinical evidence supports routine CTC determination in clinical practice. CellSearch detection system represents the first automated and standardized technology that was approved by the FDA for predicting progression and disease-free survival in metastatic breast cancer. The presence of circulating tumor cells (CTC) in peripheral blood detected circulating Tumor Cell CellSearch ® System, is associated with lower disease-free survival (DFS) and shorter overall survival (OS) in patients with metastatic breast, colorectal and prostate cancer.
Key words: Circulating tumor cells (CTC), solid tumor, metastasis.
Biografía del autor/a
Luz Fernanda Sua Villegas, Clínica de Occidente
Nhora María Silva Pérez, Fundación Valle del Lili.
Marta Vidaurreta Lázaro, Hospital Clínico San Carlos de Madrid
Sara Rafael Fernández, Hospital Clínico San Carlos de Madrid
Virginia de la Orden, Hospital Clínico San Carlos de Madrid
Silvia Veganzones de Castro, Hospital Clínico San Carlos de Madrid.
María Luisa Maestro de las Casas, Hospital Clínico San Carlos de Madrid
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