Circulating Tumour Cells

TransFix stabilised blood is compatible with a range of methods for the isolation and analysis of circulating tumour cells (CTC). The number of CTC populations present in patient blood is very low, therefore the usefulness of CTC assessments depends upon accurate cell counts and the corresponding analysis of molecular targets.

Circulating Tumour Cell TransFix/EDTA Vacuum Blood Collection Tubes (CTC-TVTs) are 9ml evacuated tubes prefilled with TransFix. CTC-TVTs are specifically designed for the optimal collection and stabilisation of CTCs in whole human blood. They allow stabilisation of CTCs for up to 5 days immediately preventing the degradation of CTCs and CTC antigens, allowing time to isolate and analyse these rare cells.

CTC Tubes are for Research Use Only.

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Circulating Tumour Cells (CTC)

Benefits of CTC-TVTs

  • Easy to use – just collect blood and mix by inversion
  • Improved cell stability facilitating recovery of rare cells
  • Immediate Stabilisation at the time point of venepuncture
  • Published examples show compatibility with a range of CTC isolation and analysis techniques:
    • Size exclusion filtration and by cellular surface markers
    • Microscopic analysis and enumeration of CTCs in metastatic breast and lung cancer patients
    • Analysis of CTCs through high-resolution image flow cytometry
    • Cell sorting and mutation analysis
    • mRNA extraction

Product Codes

CTC-TVT-09-1 Circulating Tumour Cell TransFix/EDTA 9mL Vacuum Blood Collection Tubes (1 tube)
CTC-TVT-09-2 Circulating Tumour Cell TransFix/EDTA 9mL Vacuum Blood Collection Tubes (2 tubes)
CTC-TVT-09-50 Circulating Tumour Cell TransFix/EDTA 9mL Vacuum Blood Collection Tubes (50 tubes)

Research Use Only


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  • Assessment of circulating tumor cells with a novel, filtration-based method, in a phase IIIb multicenter study for...

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  • VyCAP's Puncher Technology for Single Cell Identification, Isolation, and Analysis

    This paper focuses on the validation of the Vycap method for isolation of individual CTC's. These were analyses downstream for DNA. The authors used TransFix blood collection tubes (CTC-TVTs) to allow VyCAP single CTC isolation for up to 48 h after blood draw and preserve cell morphology while the cells do still retain a certain flexibility that allows efficient separation of the excess leukocytes, while keeping the CTC in the pore at the bottom of the microwell.
    M. Stevens, L. Oomens, J. Broekmaat, J. Weersink, F. Abali, J. Swennenhuis, A. Tibbe | 2018 | Cytometry Part A, 93(12); 1255-1259
  • Proficiency Testing to Assess Technical Performance for CTC-Processing and Detection Methods in CANCER-ID

    The authors of this paper set out to determine the technical performance of technology used in circulating tumour cell processing and the detection methods in cancer-id. Both Siemens and Parsortix recommend TransFix CTC-TVT and TVT respectively for stabilisation when using their CTC technology.
    Rui P.L. Neves, Wim Ammerlaan, Kiki C. Andree, Sebastian Bender, Laure Cayrefourcq, Christiane Driemel, Claudia Koch, Merlin Verena Luetke-Eversloh, Marianne Oulhen, Elisabetta Rossi, Catherine Alix-Panabie'res,e Fay Betsou,b Francoise Farace,g Sabine Riethdorf, Thomas Schlange, Harriet Wikman, Rita Zamarchi, Klaus Pantel, Leon W.M.M. Terstappen, and Nikolas H. Stoecklein | 2021 | Clinical Chemistry 67(4): 631-641
  • Optimization of a size-based enrichment method for improved circulating tumour cell detection in metastatic breast cancer patients

    This thesis sets out to improve enrichment method to help better circulating tumour cell detection in metastatic breast cancer patients. Different blood collection tubes were tested along with fixation and permeabilization reagents. TransFix was determined as the most optimal when combined with the FIX&PERM cell fixation and the VYCAP size-based filtration system coupled with immunofluorescent staining.
    Sol Emilie Anda, Bachelor's program in Biological Chemistry, University of Stavanger | 2023 | Bachelor thesis, University of Stravanger
  • High-resolution imaging for the detection and characterisation of circulating tumour cells from patients with oesophageal, hepatocellular, thyroid and ovarian cancers

    The purpose of this study was to develop and validate a novel, widely applicable method for detection and characterisation of circulating tumour cells from 4 tumour types. Blood samples were collected in TransFix collection tubes and stained for immunofluorescence by the following membrane antibodies and nuclear stains: EpCAM, cytokeratins 4, 5, 6, 8, 10, 13 and 18, survivin and CD45, and DAPI or DRAQ5. Circulating tumour cells were enriched using an EasySep human CD45 depletion kit, and were analysed using an ImageStream X Flow cytometer.
    B. M. Dent, L. F. Ogle, R. L. O'Donnell, N. Hayes, U. Malik, N. J. Curtin, A. V. Boddy, E. R. Plummer, R. J. Edmondson, H. L. Reeves, F. E. B. May, D. Jamieson | 2016 | International Journal of Cancer 138(1): 206-216
  • Hexokinase 2 discerns a novel circulating tumor cell population associated with poor prognosis in lung cancer patients

    This study aims to demonstrate Hexokinase-2 and its use in detecting novel circulating tumour cells. These CTCs are otherwise difficult to detect and have been linked with a bad prognosis in lung cancer patients. TransFix vaccum collection tubes were used to preserve blood cells which where then analysed using the HK2 marker
    Liu Yang, Xiaowei Yan, Jie Chen, Qiong Zhan, Yingqi Hua, Shili Xu, Ziming Li, Zhuo Wang, Yu Dong, Dongqing Zuo, Min Xue, Yin Tang, Harvey R. Herschman, Shun Lu, Qihui Shi, and Wei Wei | 2021 | PNAS 118(11) e2012228118
  • EMT-independent detection of circulating tumor cells in human blood samples and pre-clinical mouse models of metastasis

    This paper explores detecting circulating tumour cells in human blood independent of epithelial-to-mesenchymal transition and pre clinical mouse models of metastasis. CTC analysis was carried out in three different ways, Cellsearch, parsortix and Vycap. TransFix was added to each spiked mouse blood sample for the Vycap assay and left at room temperature for 24-48 hours.
    Jenna Kitz, David Goodale, Carl Postenka, Lori E. Lowes & Alison L. Allan | 2021 | Clinical & Experimental Metastasis 38: 97-108
  • Development of a method to measure acetylated histone H4 in the nuclei of circulating myeloid cells as a surrogate tissue for the pharmacodynamics of HDAC inhibitors in the treatment of solid tumors

    This conference abstract details the development and validation of an assay to measure the proportion of myeloid cells in peripheral blood with nuclei localised acetylated Histone H4 detectable by immunofluorescence and imaging flow cytometry. Blood samples treated with the potential anti-cancer agent sodium valproate were then stabilised in TransFix, stained by anti-acH4 and DAPI then analsysed by an Imagestream MkII imaging flow cytometer.
    J. David, W. Wong, G. Veal | 2015 | AACR Cancer Res 75(15 Suppl):Abstract nr 5374
  • Detection and Characterization of Circulating Tumor Associated Cells in Metastatic Breast Cancer

    This paper describes the use of the Screencell method of size-exclusion isolation of CTCs, circulating tumour cell clusters (CTC clusters), CTCs of epithelial-mesenchymal transition (EMT) and cancer associated macrophage-like cells (CAMLs). Blood samples collected in TransFix tubes and analysed within 72 hours. Cytological Analysis was performed by immunofluorescence staining of cytokeratins (CK-8, 18 and 19), DAPI, CD45 for CTCs, and EMT-CTCs were stained for Vimentin and N-Cadherin. Cell sorting was performed by the DEPArray™ system. TP53 and ESR1 Mutations in CTCs were analysed by Sanger sequencing.
    Z. Mu, N. Benali-Furet, G. Uzan, A. Znaty, Z. Ye, C. Paolillo, C. Wang, L. Austin, G. Rossi, P. Fortina, H. Yang, M. Cristofanilli | 2016 | Int. J. Mol. Sci. 17(10): 1665
  • Cytopathological Heterogeneity of Circulating Tumor Cells in Non-metastatic Esophageal Adenocarcinoma

    This study sets out to discover the cytomorphology of circulating tumour cells in non-metastatic esophageal adenocarcinoma and their heterogeneity. Size-based cell filtration was carried out to determine the size of the CTCs. TransFix CTC tubes were used for collection of blood specimens which were sent within 24hrs of collection to the CTC laboratory. CTC enrichment was performed by cell size-based filtration using the ScreenCell® Cyto kit (ScreenCell, Sarcelles, France).
    Jasmina Kuvendjiska, Martha B. Pitman, Verena Martini, Clara Braun, Kim Grebe, Sylvia Timme, Stefan Fichtner-Feigl, Torben Glatz,Claudia Schmoor, Jessica Guenzle, Jens Hoeppner and Birte Kulemann | 2020 | Anticancer Research 40: 5679-5685
  • Cancer-associated Macrophage-like Cells in Patients with Non-metastatic Adenocarcinoma of the Esophagus - Cytomorphological Heterogeneity

    This paper demonstrates the presence and phenotype of cancer-associated macrophage-like cells (CAML) as a liquid biomarker in Esophageal adenocarcinoma (EAC) patients. Peripheral venous blood samples were taken before initiating any neoadjuvant treatment using Circulating Tumour Cell TransFix/ EDTA Vacuum Blood Collection Tubes, to facilitate shipping and storage for up to 5 days, before CAMLs were isolated using ScreenCell® Cyto-R devices (ScreenCell, Sarcelles, France), then stained with standard May-GrunwaldGiemsa-staining for cytological analysis.
    Clara Braun, Claudia Schmoor, Sylvia Timme-Bronsert, Stefan Fichtner-Feigl, Jens Hoeppner, Birte Kulemann, and Jasmina Kuvendjiska | 2023 | J Cancer 2023; 14(11):2152-2160
  • A Novel Strategy for Detection and Enumeration of Circulating Rare Cell Populations in Metastatic Cancer Patients Using Automated Microfluidic Filtration and Multiplex Immunoassay

    In this study, the performance of a novel approach for detection and enumeration of multiple rare cell populations was evaluated in the blood of metastatic breast and lung cancer patients using an automated microfluidic filtration and multiplex immunoassay strategy. Different circulating rare cell populations were detected and enumerated, including circulating tumour cells (CTCs), circulating mesenchymal cells (CMCs), circulating endothelial cells (CECs), and putative circulating stem cells (CSCs). Simultaneous assessment of CTCs, CMCs, CSCs and CECs may provide new tools to study mechanisms of disease progression and treatment response/resistance. The highly controlled filtration process and the multi-step staining parameters were optimised to minimise the detection of false positives in healthy donor blood. Use of TransFix®, along with controlled shipping and storage conditions contributed to the high rate of reportable results (98%). Blood was collected into tubes containing K3EDTA and 0.45mL TransFix® in customised TransFix/EDTA Vacuum Blood Collection Tubes (CTC-TVT-09-50).
    M. J. M. Magbanua, M. Pugia, J. S. Lee, M. Jabon, V. Wang, M. Gubens, K. Marfurt, J. Pence, H. Sidhu, A. Uzgiris, H. S. Rugo, J. W. Park | 2015 | PLoS ONE 10(10): e0141166
  • 4EVER: Assessment of circulating tumor cells with a novel, filtration-based method, in a phase IIIb multicenter study for postmenopausal, HER2-negative, estrogen receptor-positive, advanced breast cancer patients

    The presence of circulating tumor cells (CTC's) has been shown to be of diagnostic relevance for patients with early and advanced breast cancer (BC) The usefulness of CTC assessments depends upon accurate cell counts and the corresponding analysis of molecular targets. Patient blood samples were preserved using TransFix vacuum blood collection tubes and CTC's were detected by image analytics after fluorescence scanning microscopy. The clinical trial is ongoing.
    P. A. Fasching et al | 2013 | J Clin Oncol 31 (suppl; abstract 591)
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