{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:48:14Z","timestamp":1787028494174,"version":"build-2736575974"},"reference-count":73,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Circulating tumor cells (CTCs) have been detected in many patients with different solid malignancies. It has been reported that presence of CTCs correlates with worse survival in patients with multiple types of cancer. Several techniques have been developed to detect CTCs in liquid biopsies. Currently, the only method for CTC detection that is approved by the Food and Drug Administration is CellSearch. Due to low abundance of CTCs in certain cancer types and in early stages of disease, its clinical application is currently limited to metastatic colorectal cancer, breast cancer and prostate cancer. Therefore, we aimed to develop a new method for the detection of CTCs using the Attune NxT\u2014a flow cytometry-based application that was specifically developed to detect rare events in biological samples without the need for enrichment. When healthy donor blood samples were spiked with variable amounts of different EpCAM+EGFR+ tumor cell lines, recovery yield was on average 75%. The detection range was between 1000 and 10 cells per sample. Cell morphology was confirmed with the Attune CytPix. Analysis of blood samples from metastatic colorectal cancer patients, as well as lung cancer patients, demonstrated that increased EpCAM+EGFR+ events were detected in more than half of the patient samples. However, most of these cells showed no (tumor) cell-like morphology. Notably, CellSearch analysis of blood samples from a subset of colorectal cancer patients did not detect CTCs either, suggesting that these blood samples were negative for CTCs. Therefore, we anticipate that the Attune NxT is not superior to CellSearch in detection of low amounts of CTCs, although handling and analysis of samples is easier. Moreover, morphological confirmation is essential to distinguish between CTCs and false positive events.<\/jats:p>","DOI":"10.3390\/ijms24010021","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T04:45:53Z","timestamp":1671511553000},"page":"21","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Detection of Circulating Tumor Cells Using the Attune NxT"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1965-1500","authenticated-orcid":false,"given":"Mandy","family":"Gruijs","sequence":"first","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Molecular Cell Biology and Immunology, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, Cancer Immunology, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolien","family":"Zeelen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Molecular Cell Biology and Immunology, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, Cancer Immunology, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Hellingman","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Surgery, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Smit","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute\u2014Antoni van Leeuwenhoek Hospital, Thoracic Oncology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Borm","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Pulmonology, Albinusdreef 2, Leiden 2333 ZB, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert","family":"Kazemier","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Surgery, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Dickhoff","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Cardiothoracic Surgery, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idris","family":"Bahce","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Pulmonology, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joop","family":"de Langen","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute\u2014Antoni van Leeuwenhoek Hospital, Thoracic Oncology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egbert F.","family":"Smit","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Pulmonology, Albinusdreef 2, Leiden 2333 ZB, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen J.","family":"Hartemink","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute\u2014Antoni van Leeuwenhoek Hospital, Surgery, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein","family":"van Egmond","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Molecular Cell Biology and Immunology, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands"},{"name":"Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam 1081 HV, The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity, Cancer 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