Circulating tumor cell (CTC) detection and numeration are becoming part of the common clinical practice, especially for breast, colon, and prostate cancer. However, their paucity in peripheral blood samples is an obstacle for their identification. Several groups have tried to improve CTC recovery rate by developing highly sensitive cellular and molecular detection methods. However, CTCs are still difficult to detect in peripheral blood. Therefore, their recovery rate could be increased by obtaining blood samples from vessels close to the drainage territories of the invaded organ, when the anatomical situation is favorable. This approach has been tested mostly during tumor resection surgery, when the vessels nearest to the tumor are easily accessible. Moreover, radiological (including echo-guided based and endovascular techniques) and/or endoscopic routes could be utilized to obtain CTC samples close to the tumor in a less invasive way than conventional biopsies. The purpose of this article is to summarize the available knowledge on CTC recovery from blood samples collected close to the tumor (i.e., in vessels located in the drainage area of the primary tumor or metastases). The relevance of such an approach for diagnostic and prognostic evaluations will be discussed, particularly for pancreatic ductal adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, and non-small-cell lung cancer.

中文翻译：

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肿瘤近端活检可改善循环肿瘤细胞的诊断和预后性能。

循环肿瘤细胞（CTC）的检测和计数正在成为常见临床实践的一部分，尤其是对于乳腺癌，结肠癌和前列腺癌。但是，它们在外周血样中的缺乏是它们鉴定的障碍。几个小组已经尝试通过开发高度灵敏的细胞和分子检测方法来提高四氯化碳的回收率。但是，在外周血中仍然很难检测到四氯化碳。因此，当解剖情况良好时，可以通过从靠近被侵袭器官引流区域的血管中获取血样来提高其恢复率。这种方法主要是在肿瘤切除手术中经过测试的，这时可以很容易地接近最接近肿瘤的血管。此外，放射学（包括基于回声引导的血管内技术和/或血管内技术）和/或内窥镜检查路线可用于以比传统活检术更不具侵入性的方式获得靠近肿瘤的CTC样品。本文的目的是总结从肿瘤附近（即位于原发肿瘤或转移灶引流区的血管中）收集的血液样本中有关四氯化碳回收的现有知识。将讨论这种方法对诊断和预后评估的相关性，特别是对于胰管腺癌，大肠腺癌，肝细胞癌和非小细胞肺癌。本文的目的是总结从肿瘤附近（即位于原发肿瘤或转移灶引流区的血管中）采集的血液样本中有关四氯化碳回收的现有知识。将讨论这种方法对诊断和预后评估的相关性，特别是对于胰管腺癌，大肠腺癌，肝细胞癌和非小细胞肺癌。本文的目的是总结从肿瘤附近（即位于原发肿瘤或转移灶引流区的血管中）采集的血液样本中有关四氯化碳回收的现有知识。将讨论这种方法对诊断和预后评估的相关性，特别是对于胰管腺癌，大肠腺癌，肝细胞癌和非小细胞肺癌。