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Micrometastatic Circulating Tumor cells - A Challenge for an Early Detection and Better Survival Rates

Yahya Tamimi, Ishita Gupta, Mansour Al-Moundhri and Ikram Burney

Micrometastasis is a health burden affecting a large population worldwide, where early stage circulating tumor cells are clinically below the detection limit of the currently used techniques in diagnosis. These cells are considered one of the sources related to the disease spread, usually associated with poor prognosis and resistant to conventional therapies. With the recent advances in technology, various molecular and biological techniques including cytological examination, RT-PCR immunocytochemistry, immuno-magnetic separation and cell-enrichment techniques have emerged to improve the early detection of circulating tumor cells in different carcinomas. However, the sensitivity and specificity of these techniques along with their prognostic influence are still contested. This review aims to discuss the role of key player molecules including cell adhesion molecules, integrins and proteases in promoting micrometastasis and the current techniques used for an early detection of these malignant cells. Understanding mechanisms underlying this invasive process, will pave the way for designing new tools to unravel difficulties associated with early detection of CTCs and will improve therapies.

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