Circulating tumor cells (CTCs) indicate the diagnosis and prognosis of cancer patients, together with benefiting individual treatment and anticancer drug development. However, their large‐scale application in general population still requires systematically multifaceted modifications for currently proprietary new technologies based on filtration. We primitively utilized a cell size‐based platform to evaluate the recovery efficiency of spiked abnormal cell lines and analyzed circulating abnormal cells (CACs). To dissect the subpopulations of CACs, we conducted immunofluorescent (IF) staining with a combination of unique biomarkers of CTCs and circulating endothelial cells (CECs). Furthermore, we improved the CTC screening system by assessing the feasibility of transferring CTCs for automatic IF analysis, together with simulating and optimizing the circumstances for long‐term CTC storage and transportation. We detected CACs in 15 HD candidates with CTC characteristics such as abnormally large cytomorphology, high nuclear−cytoplasmic ratio, and positive for panCK or VIM staining. Thereafter, we improved accuracy of the platform by distinguishing CTCs from CECs, which satisfied the elementary requirement for small‐scale CTC screening in HD candidates. Finally, large‐scale CTC screening in general population was available after multifaceted modifications including automatic analysis by transferring CTCs on slides, choosing the appropriate blood‐collecting tube, optimizing the conditions for long‐term CTC storage and transportation, and evaluating the potential effect on the CTC phenotype. Hence, we systematically modified the scope of technique parameters, improved the accuracy of early cancer detection, and made it realizable for large‐scale CTC or CEC screening in general population.

中文翻译：

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基于细胞大小的循环肿瘤细胞范围技术的多方面修改有望在一般人群中大规模应用

循环肿瘤细胞（CTC）指示癌症患者的诊断和预后，同时有利于个体治疗和抗癌药物开发。然而，它们在普通人群中的大规模应用仍然需要对目前基于过滤的专有新技术进行系统的多方面修改。我们最初利用基于细胞大小的平台来评估加标异常细胞系的恢复效率并分析循环异常细胞 (CAC)。为了剖析 CAC 的亚群，我们结合 CTC 和循环内皮细胞 (CEC) 的独特生物标志物进行了免疫荧光 (IF) 染色。此外，我们通过评估转移 CTC 进行自动 IF 分析的可行性来改进 CTC 筛选系统，以及模拟和优化 CTC 长期储存和运输的环境。我们在 15 名具有 CTC 特征的 HD 候选者中检测到 CAC，例如异常大的细胞形态学、高核质比以及 panCK 或 VIM 染色阳性。此后，我们通过区分 CTC 和 CEC 来提高平台的准确性，这满足了 HD 候选者中小规模 CTC 筛选的基本要求。最后，经过多方面的修改，包括通过将 CTC 转移到载玻片上进行自动分析、选择合适的采血管、优化长期 CTC 储存和运输条件以及评估对 CTC 的潜在影响等多方面修改后，可以在普通人群中进行大规模 CTC 筛查。 CTC 表型。因此，