Tyramide signal amplification-based detection system: A novel approach to improve detection efficiency for circulating tumor cells

Circulating tumor cells (CTCs) are recognized as pivotal mediators in tumor metastasis, intricately linked to the onset, progression, dissemination, and persistence of cancer. Analyzing CTCs clinically can offer profound insights into patient prognosis, guide the selection of treatment regimens, assess therapeutic efficacy, and provide early warnings of recurrence and metastasis. However, the extremely low abundance of CTCs in the bloodstream poses significant challenges to traditional detection methods, resulting in low detection efficiency and high false-negative rates. To overcome this hurdle, the present study leverages the principles of tyramide signal amplification (TSA) technology to devise an efficient TSA-CTC detection system. In the simulated CTC samples with cultured cancer cells added to the blood of healthy donors, this innovative system markedly boosts the detection efficiency of TSA-CTC system, especially those exhibiting weak expression of tumor markers. In the clinical CTC samples, TSA-CTC system significantly enhances the efficiency of CTC isolation and detection (p = 0.0374) by 2.6 folds change in CTC counts of lung cancer, and 4.0 folds change of breast cancer (p = 0.0225), and 3.7 folds change of gastric cancer (p = 0.0381), and reveals notable differences (p = 0.0015) between healthy individuals and lung cancer patients. The quantities of CTCs are found to be intimately correlated with tumor size (p = 0.0452), stages (p = 0.0111), and metastasis risk (p = 0.0248). This study offers novel perspectives on the enrichment, isolation, and detection of CTCs, furnishing robust evidence and potent tools for clinical research on cancer.