Summary: | Somayeh Vafaei,1–3 Fahimeh Fattahi,1,2 Marzieh Ebrahimi,3 Leila Janani,4 Ahmad Shariftabrizi,5 Zahra Madjd1,6 1Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; 2Student Research Committee, Iran University of Medical Sciences, Tehran, Iran; 3Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; 4Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; 5Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; 6Oncopathology Research Center, Iran University of Medical Sciences, Tehran, IranCorrespondence: Zahra MadjdOncopathology Research Center, Department of Molecular Medicine, Iran University of Medical Sciences (IUMS), Hemmat Street (Highway), Next to Milad Tower, Tehran 14496-14530, IranTel +98 218 670 3212Fax +98 218 862 2608Email Zahra.madjd@yahoo.comMarzieh EbrahimiDepartment of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran 16635-148, IranTel +98 2 356 2516Email mebrahimi@royaninstitute.orgAbstract: Nearly half of patients with colorectal cancer (CRC), the third leading cause of cancer deaths worldwide, are diagnosed in the late stages of the disease. Appropriate treatment is not applied in a timely manner and nearly 90% of the patients who experience metastasis ultimately die. Timely detection of CRC can increase the five-year survival rate of patients. Existing histopathological and molecular classifications are insufficient for prediction of metastasis, which limits approaches to treatment. Detection of reliable cancer-related biomarkers can improve early diagnosis, prognosis, and treatment response prediction and recurrence risk. Circulating tumor cells (CTCs) and exosomes in peripheral blood can be used in a liquid biopsy to assess the status of a tumor. Exosomes are abundant and available in all fluids of the body, have a high half-life and are released by most cells. Tumor-derived exosomes are released from primary tumors or CTCs with selective cargo that represents the overall tumor. The current systematic review highlights new trends and approaches in the detection of CRC biomarkers to determine tumor signatures using CTC and exosomes. When these are combined, they could be used to guide molecular pathology and can revolutionize detection tools. Relevant observational studies published until July 24, 2019 which evaluated the expression of tumor markers in CTCs and exosomes were searched in PubMed, Scopus, Embase, and ISI Web of Science databases. The extracted biomarkers were analyzed using String and EnrichR tools.Keywords: colorectal cancer, circulating tumor cell, CTC, exosomes, diagnosis, prognosis, biomarker, systematic review
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