Circulating Tumor Cell Analysis: Technical and Statistical Considerations for Application to the Clinic
Table 2
Advantages and disadvantages of currently used methods of CTC analysis.
Method
Estimated sensitivity
Advantages
Disadvantages
Selected references
PCR-based approaches
10-4–10-6
(i) Rapid, quantitative(ii) High sensitivity(iii) Small sample volume required
(i) Does not allow for cell-by-cell analysis(ii) Does not discriminate between viable and nonviable cells(iii) Low specificity(iv) Technical issues with mRNA degradation, etc.
(i) Rapid, quantitative(ii) Cell-by-cell analysis(iii) Multiparameter(iv) High specificity(v) Identification of viable versus nonviable cells(vi) Potential to sort CTCs for additional characterization
(i) Limited sensitivity(ii) Requirement for large sample volume unless sample enrichment used(iii) No visual confirmation of cell specificity(iv) Technically and analytically challenging
(i) High sensitivity and specificity(ii) Automated, quantitative(iii) Highly reproducible(iv) Moderate sample volume needed(v) Identification of viable versus nonviable cells(vi) Commercially available(vii) Only assay with FDA approval
(i) Limited analysis parameters(ii) Use of EpCam to capture CTCs may miss some tumor cells(iii) Multiple enrichment and processing steps may result in loss of CTCs(iv) Partially subjective readout
(i) High sensitivity and specificity(ii) Quantitative(iii) Minimal processing and shear stress(iv) Identification of viable versus nonviable cells(v) Potential to recover CTCs for additional characterization
(i) Technology is not commercially available(ii) Use of EpCam to capture CTCs may miss some tumor cells(iii) Partially subjective readout
