Clinical and Translational Oncology

, Volume 21, Issue 7, pp 828–835 | Cite as

Integrative diagnosis of cancer by combining CTCs and associated peripheral blood cells in liquid biopsy

  • W.-W. Zhang
  • Y. Rong
  • Q. Liu
  • C.-L. Luo
  • Y. Zhang
  • F.-B. WangEmail author
Review Article


Circulating tumor cells (CTCs), as cells shed from solid tumor into the vasculature, play a significant role in tumor metastasis. In the peripheral blood, immune cells and stromal cells can interact with CTCs and influence their biological behaviors of survival, proliferation, dissemination, and immune evasion. These peripheral blood cells can evolve synergistically with CTCs to constitute the liquid microenvironment which is essential for tumor progression. Here, we review the mechanisms of peripheral blood cells interacting with CTCs and uncover their effects on both CTCs and tumor metastasis. Then, we introduce the applications of these CTC-associated peripheral blood cells in the clinical setting. Besides, some peripheral blood cell subsets are of additional clinical values to CTCs in cancer diagnosis and prognosis. To improve the clinical utility of CTCs, an integrative analysis of CTCs and associated peripheral blood cells should be advocated for, which could provide a novel insight into tumor biology and offer comprehensive information in cancer diagnosis, prognosis, and therapy efficacy evaluation.


Cancer Diagnosis CTC Peripheral blood cells Interaction Liquid biopsy 



This work was supported by Science and Technology Innovation Fostering Foundation of Zhongnan Hospital of Wuhan University (cxpy20160025), and National Natural Science Foundation of China (No. 81672114). This work was also funded by Applied Basic Research Program of Science and Technology Bureau Foundation of Wuhan (No. 2016060101010054) and Wuhan City health and family planning medical talented youth development project.

Author contributions

F-BW, WWZ, and YR conceived and designed the study. WWZ and YR drafted the manuscript. QL and YZ participated in the literature search and graphic design.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no any conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the author.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Department of Laboratory MedicineZhongnan Hospital of Wuhan UniversityWuhanPeople’s Republic of China
  2. 2.HERM, Department of Medicine HuddingeKarolinska InstitutetSolnaSweden
  3. 3.Cedars-Sinai Medical CenterBiomedical Imaging Research InstituteLos AngelesUSA

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