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A simple biological imaging system for detecting viable human circulating tumor cells
Toru Kojima, Yuuri Hashimoto, Yuichi Watanabe, Shunsuke Kagawa, Futoshi Uno, Shinji Kuroda, Hiroshi Tazawa, Satoru Kyo, Hiroyuki Mizuguchi, Yasuo Urata, Noriaki Tanaka, Toshiyoshi Fujiwara
Toru Kojima, Yuuri Hashimoto, Yuichi Watanabe, Shunsuke Kagawa, Futoshi Uno, Shinji Kuroda, Hiroshi Tazawa, Satoru Kyo, Hiroyuki Mizuguchi, Yasuo Urata, Noriaki Tanaka, Toshiyoshi Fujiwara
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Technical Advance Oncology

A simple biological imaging system for detecting viable human circulating tumor cells

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Abstract

The presence of circulating tumor cells (CTCs) in the peripheral blood is associated with short survival, making the detection of CTCs clinically useful as a prognostic factor of disease outcome and/or a surrogate marker of treatment response. Recent technical advances in immunocytometric analysis and quantitative real-time PCR have made it possible to detect a few CTCs in the blood; however, there is no sensitive assay to specifically detect viable CTCs. Here, we report what we believe to be a new approach to visually detect live human CTCs among millions of peripheral blood leukocytes, using a telomerase-specific replication-selective adenovirus expressing GFP. First, we constructed a GFP-expressing attenuated adenovirus, in which the telomerase promoter regulates viral replication (OBP-401; TelomeScan). We then used OBP-401 to establish a simple ex vivo method that was able to detect viable human CTCs in the peripheral blood. The detection method involved a 3-step procedure, including the lysis of rbc, the subsequent addition of OBP-401 to the cell pellets, and an automated scan using fluorescence microscopy. OBP-401 infection increased the signal-to-background ratio as a tumor-specific probe, because the fluorescent signal was amplified only in viable, infected human tumor cells, by viral replication. This GFP-expressing virus-based method is remarkably simple and allows precise enumeration of CTCs.

Authors

Toru Kojima, Yuuri Hashimoto, Yuichi Watanabe, Shunsuke Kagawa, Futoshi Uno, Shinji Kuroda, Hiroshi Tazawa, Satoru Kyo, Hiroyuki Mizuguchi, Yasuo Urata, Noriaki Tanaka, Toshiyoshi Fujiwara

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Figure 7

CTC dynamics at baseline and after treatment in patients with gastric or colon cancer.

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CTC dynamics at baseline and after treatment in patients with gastric or...
(A) Quantitation of CTCs in peripheral blood samples from an advanced gastric cancer patient (case 1) with multiple liver metastases who received 2 cycles of systemic chemotherapy. CTC counts at the indicated time points (orange bars) were plotted along with the levels of tumor markers CEA, CA19-9, and CA125. A decrease in the CTC number from 7 to 0 was observed 38 days after starting chemotherapy (red arrows). (B) The patient with recurrent gastric cancer at regional lymph nodes (case 27) was treated with 2 cycles of systemic chemotherapy. The CTC quantity (orange bars) and CEA level were well correlated over the course of treatment. (C and D) Changes in CTC numbers after surgery. CTC numbers were measured before and 4 weeks after surgical resection of primary tumors and regional lymph node dissection. (C) Two gastric cancer patients (cases 5 and 9) underwent a total gastrectomy and distal gastrectomy, respectively. (D) Low anterior resection was performed in 2 colorectal cancer patients (cases 3 and 4).

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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