Ultra-fast, label-free isolation of circulating tumor cells from blood using spiral microfluidics

Circulating tumor cells (CTCs) are rare cancer cells that are shed from primary or metastatic tumors into the peripheral blood circulation. Phenotypic and genetic characterization of these rare cells can provide important information to guide cancer staging and treatment, and thus further research into their characteristics and properties is an area of considerable interest. In this protocol, we describe detailed procedures for the production and use of a label-free spiral microfluidic device to allow size-based isolation of viable CTCs using hydrodynamic forces that are present in curvilinear microchannels. This spiral system enables us to achieve ≥85% recovery of spiked cells across multiple cancer cell lines and 99.99% depletion of white blood cells in whole blood. The described spiral microfluidic devices can be produced at an extremely low cost using standard microfabrication and soft lithography techniques (2–3 d), and they can be operated using two syringe pumps for lysed blood samples (7.5 ml in 12.5 min for a three-layered multiplexed chip). The fast processing time and the ability to collect CTCs from a large patient blood volume allows this technique to be used experimentally in a broad range of potential genomic and transcriptomic applications.

[1]  Robert Rosenberg,et al.  Detection of circulating tumor cells in blood using an optimized density gradient centrifugation. , 2003, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[2]  Chwee Teck Lim,et al.  Versatile label free biochip for the detection of circulating tumor cells from peripheral blood in cancer patients. , 2010, Biosensors & bioelectronics.

[3]  Yi-Kuen Lee,et al.  Highly efficient capture of circulating tumor cells by using nanostructured silicon substrates with integrated chaotic micromixers. , 2011, Angewandte Chemie.

[4]  G. Segré,et al.  Behaviour of macroscopic rigid spheres in Poiseuille flow Part 2. Experimental results and interpretation , 1962, Journal of Fluid Mechanics.

[5]  J. Fagerberg,et al.  Side-by-side analysis of five clinically tested anti-EpCAM monoclonal antibodies , 2010, Cancer Cell International.

[6]  Wei Yin,et al.  The Identification and Characterization of Breast Cancer CTCs Competent for Brain Metastasis , 2013, Science Translational Medicine.

[7]  Jaap M J den Toonder,et al.  Circulating tumor cell isolation and diagnostics: toward routine clinical use. , 2011, Cancer research.

[8]  Tuan Zea Tan,et al.  Short-term expansion of breast circulating cancer cells predicts response to anti-cancer therapy , 2015, Oncotarget.

[9]  M. Peters,et al.  Cellular and complement-dependent cytotoxicity of Ep-CAM-specific monoclonal antibody MT201 against breast cancer cell lines , 2005, British Journal of Cancer.

[10]  Peter C. Y. Chen,et al.  Slanted spiral microfluidics for the ultra-fast, label-free isolation of circulating tumor cells. , 2014, Lab on a chip.

[11]  J Christopher Love,et al.  Towards Engineered Processes for Sequencing-Based Analysis of Single Circulating Tumor Cells. , 2014, Current opinion in chemical engineering.

[12]  S. G. Mason,et al.  The flow of suspensions through tubes: V. Inertial effects , 1966 .

[13]  Sridhar Ramaswamy,et al.  Circulating Tumor Cell Clusters Are Oligoclonal Precursors of Breast Cancer Metastasis , 2014, Cell.

[14]  Edward J Park,et al.  Detection and isolation of circulating tumor cells: principles and methods. , 2013, Biotechnology advances.

[15]  A. Jemal,et al.  Global cancer statistics , 2011, CA: a cancer journal for clinicians.

[16]  John W. Park,et al.  Circulating Tumor Cells , 2017, Methods in Molecular Biology.

[17]  T. Fehm,et al.  Detection and HER2 Expression of Circulating Tumor Cells: Prospective Monitoring in Breast Cancer Patients Treated in the Neoadjuvant GeparQuattro Trial , 2010, Clinical Cancer Research.

[18]  Christian Wittekind,et al.  Cancer Invasion and Metastasis , 2005, Oncology.

[19]  A. Weiss,et al.  Detection and characterization of carcinoma cells in the blood. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[20]  C. Lim,et al.  Ultra-High Throughput Enrichment of Viable Circulating Tumor Cells , 2014 .

[21]  A. Bhagat,et al.  Continuous particle separation in spiral microchannels using Dean flows and differential migration. , 2008, Lab on a chip.

[22]  James T. Wu,et al.  Cell-free DNA: measurement in various carcinomas and establishment of normal reference range. , 2002, Clinica chimica acta; international journal of clinical chemistry.

[23]  M. Tachibana,et al.  On the behaviour of a sphere in the laminar tube flows , 1973 .

[24]  R. Tompkins,et al.  Continuous inertial focusing, ordering, and separation of particles in microchannels , 2007, Proceedings of the National Academy of Sciences.

[25]  Kenry,et al.  Microfluidics for research and applications in oncology. , 2016, The Analyst.

[26]  Michael K. Schwartz Molecular Characterization of CTCs , 2013 .

[27]  G Kvalheim,et al.  Standardization of the immunocytochemical detection of cancer cells in BM and blood: I. establishment of objective criteria for the evaluation of immunostained cells. , 1999, Cytotherapy.

[28]  R. Matkowski,et al.  Circulating Tumor , 2014 .

[29]  P. Friedl,et al.  Collective cell migration in morphogenesis, regeneration and cancer , 2009, Nature Reviews Molecular Cell Biology.

[30]  T. Maudelonde,et al.  Detection of circulating prostate-specific antigen-secreting cells in prostate cancer patients. , 2005, Clinical chemistry.

[31]  Yong-Seok Choi,et al.  Supplementary Material (esi) for Lab on a Chip Lateral and Cross-lateral Focusing of Spherical Particles in a Square Microchannel , 2022 .

[32]  A. Manz,et al.  Lab-on-a-chip: microfluidics in drug discovery , 2006, Nature Reviews Drug Discovery.

[33]  G. Segré,et al.  Radial Particle Displacements in Poiseuille Flow of Suspensions , 1961, Nature.

[34]  C. Lim,et al.  Microfluidic Platforms for Human Disease Cell Mechanics Studies , 2013 .

[35]  E. Kohn,et al.  Cancer invasion and metastasis. , 1993, Hospital practice.

[36]  C. Lim,et al.  Isolation and retrieval of circulating tumor cells using centrifugal forces , 2013, Scientific Reports.

[37]  G. Whitesides The origins and the future of microfluidics , 2006, Nature.

[38]  E. Yagüe,et al.  Viable circulating tumour cell detection using multiplex RNA in situ hybridisation predicts progression-free survival in metastatic breast cancer patients , 2012, British Journal of Cancer.

[39]  M. Tan,et al.  The significance of circulating epithelial cells in Breast Cancer patients by a novel negative selection method , 2008, Breast Cancer Research and Treatment.

[40]  Susan G Hilsenbeck,et al.  Intrinsic resistance of tumorigenic breast cancer cells to chemotherapy. , 2008, Journal of the National Cancer Institute.

[41]  J. Chalmers,et al.  Optimization of an enrichment process for circulating tumor cells from the blood of head and neck cancer patients through depletion of normal cells , 2009, Biotechnology and bioengineering.

[42]  Feng Zhang,et al.  Nanoroughened surfaces for efficient capture of circulating tumor cells without using capture antibodies. , 2013, ACS nano.

[43]  J. Massagué,et al.  Cancer Metastasis: Building a Framework , 2006, Cell.

[44]  S. Digumarthy,et al.  Isolation of rare circulating tumour cells in cancer patients by microchip technology , 2007, Nature.

[45]  W. R. Dean Fluid Motion in a Curved Channel , 1928 .

[46]  Rajan P Kulkarni,et al.  Size-selective collection of circulating tumor cells using Vortex technology. , 2014, Lab on a chip.

[47]  Hans Clevers,et al.  Organoid Cultures Derived from Patients with Advanced Prostate Cancer , 2014, Cell.

[48]  Nicole K Henderson-Maclennan,et al.  Deformability-based cell classification and enrichment using inertial microfluidics. , 2011, Lab on a chip.

[49]  Ali Asgar S. Bhagat,et al.  Clinical Validation of an Ultra High-Throughput Spiral Microfluidics for the Detection and Enrichment of Viable Circulating Tumor Cells , 2014, PloS one.

[50]  Eugene J. Lim,et al.  Microfluidic, marker-free isolation of circulating tumor cells from blood samples , 2014, Nature Protocols.

[51]  Gwo-Bin Lee,et al.  High-purity and label-free isolation of circulating tumor cells (CTCs) in a microfluidic platform by using optically-induced-dielectrophoretic (ODEP) force. , 2013, Lab on a chip.

[52]  Kyung-A Hyun,et al.  Microfluidic flow fractionation device for label-free isolation of circulating tumor cells (CTCs) from breast cancer patients. , 2013, Biosensors & bioelectronics.

[53]  Katharina Pachmann,et al.  Standardized quantification of circulating peripheral tumor cells from lung and breast cancer , 2005, Clinical chemistry and laboratory medicine.

[54]  Alison Stopeck,et al.  Circulating tumor cells: a novel prognostic factor for newly diagnosed metastatic breast cancer. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[55]  Maciej Zborowski,et al.  Enrichment of rare cancer cells through depletion of normal cells using density and flow-through, immunomagnetic cell separation. , 2004, Experimental hematology.

[56]  Anil K Sood,et al.  A novel platform for detection of CK+ and CK- CTCs. , 2011, Cancer discovery.

[57]  W. Kemmner,et al.  Currently Used Markers for CTC Isolation - Advantages, Limitations and Impact on Cancer Prognosis , 2011 .

[58]  Jason P. Gleghorn,et al.  Capture of circulating tumor cells from whole blood of prostate cancer patients using geometrically enhanced differential immunocapture (GEDI) and a prostate-specific antibody. , 2010, Lab on a chip.

[59]  N. Lane,et al.  Methods for isolating circulating epithelial cells and criteria for their classification as carcinoma cells. , 2005, Cytotherapy.

[60]  H. Jung,et al.  Continuous separation of breast cancer cells from blood samples using multi-orifice flow fractionation (MOFF) and dielectrophoresis (DEP). , 2011, Lab on a chip.

[61]  M. Lacroix,et al.  Significance, detection and markers of disseminated breast cancer cells. , 2006, Endocrine-related cancer.

[62]  C. Lim,et al.  Isoporous micro/nanoengineered membranes. , 2013, ACS nano.

[63]  Elisabeth Guazzelli,et al.  Inertial migration of rigid spherical particles in Poiseuille flow , 2004, Journal of Fluid Mechanics.

[64]  Ciprian Iliescu,et al.  Label-free isolation of circulating tumor cells in microfluidic devices: Current research and perspectives. , 2013, Biomicrofluidics.

[65]  Sridhar Ramaswamy,et al.  Ex vivo culture of circulating breast tumor cells for individualized testing of drug susceptibility , 2014, Science.

[66]  A. Bhagat,et al.  Inertial microfluidics for continuous particle separation in spiral microchannels. , 2009, Lab on a chip.

[67]  John B. Shoven,et al.  I , Edinburgh Medical and Surgical Journal.

[68]  Mieke Schutte,et al.  Anti-Epithelial Cell Adhesion Molecule Antibodies and the Detection of Circulating Normal-Like Breast Tumor Cells , 2009, Journal of the National Cancer Institute.

[69]  S. Morrison,et al.  Prospective identification of tumorigenic breast cancer cells , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[70]  Mehmet Toner,et al.  Detection of mutations in EGFR in circulating lung-cancer cells. , 2008, The New England journal of medicine.

[71]  Mehmet Toner,et al.  Inertial Focusing for Tumor Antigen–Dependent and –Independent Sorting of Rare Circulating Tumor Cells , 2013, Science Translational Medicine.

[72]  Daniela Massi,et al.  Application of a filtration- and isolation-by-size technique for the detection of circulating tumor cells in cutaneous melanoma. , 2010, The Journal of investigative dermatology.

[73]  Sridhar Ramaswamy,et al.  Circulating Breast Tumor Cells Exhibit Dynamic Changes in Epithelial and Mesenchymal Composition , 2013, Science.

[74]  C. Lim,et al.  Tumor dissemination: an EMT affair. , 2013, Cancer cell.

[75]  D. Di Carlo Inertial microfluidics. , 2009, Lab on a chip.

[76]  M. Keeney,et al.  Circulating Tumor Cell Analysis: Technical and Statistical Considerations for Application to the Clinic , 2009, Journal of oncology.

[77]  A. Jemal,et al.  Global Cancer Statistics , 2011 .

[78]  D. Hayes,et al.  The measurement and therapeutic implications of circulating tumour cells in breast cancer , 2005, British Journal of Cancer.

[79]  Jongyoon Han,et al.  An ultra-high-throughput spiral microfluidic biochip for the enrichment of circulating tumor cells. , 2014, The Analyst.