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Liquid Biopsy Using Whole Blood from Testis Tumor and Colon Cancer Patients—A New and Simple Way?

Majewski, Matthäus1; Nestler, Tim2; Kägler, Sebastian3; Richardsen, Ines4; Ruf, Christian, G.2; Matthies, Cord3; Willms, Arnulf4; Schmelz, Hans-Ulrich2; Wagner, Walter3; Schwab, Robert4; Abend, Michael1

doi: 10.1097/HP.0000000000000867

Tumor cells shed exosomes, which are released to the blood. Detecting tumor-derived exosomes containing RNA in plasma (liquid biopsy) is currently being investigated for early identification of occult metastases or relapses. Isolation of exosomes is laborious, resulting in low RNA yields. As a more robust (but less sensitive) alternative, the authors examined whether whole blood can be used as well. Tumor samples from nonmetastasized seminoma (n = 5) and colon cancer patients (n = 6) were taken during surgery. Whole-blood samples were taken before and 5–7 d after surgery. A whole genome mRNA microarray screening was performed. Candidate genes were selected based on two criteria: (1) gene expression in the presurgical whole-blood sample/tumor biopsy; and (2) a two-fold decrease in the copy number of candidate genes was expected in the postsurgical whole-blood sample 5–7 d after intervention, relative to the presurgical blood sample. The rationale behind this is the loss of tumor material in the body and the decline in the release of tumor-derived RNA in exosomes. For both tumor entities and for each patient, several hundred candidate genes could be identified. In a group-wise comparison, 20 candidate genes could be identified in the seminoma and 32 in the colon cancer group. These findings indicate that whole blood might be suitable for a liquid biopsy. However, this study identified the short period after surgery (5–7 d) as a possible confounder. The authors plan to add an additional time point several weeks after the operation to discriminate tumor candidate genes from genes induced by the surgery.

1Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Neuherbergstraße 11, 80804, Munich, Germany;

2Department of Urology, Bundeswehr Central Hospital, Rübenacher Str. 170, 56072 Koblenz, Germany;

3Department of Urology, Bundeswehr Hospital Hamburg, Lesserstraße 180, 22049 Hamburg, Germany;

4Department of General, Visceral, and Thoracic Surgery, Bundeswehr Central Hospital, Rübenacher Str. 170, 56072 Koblenz, Germany.

The authors declare no conflicts of interest.

For correspondence contact: Matthäus Majewski, Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Neuherbergstrasse 11, 80804, Munich, Germany, or email at

(Manuscript accepted 5 February 2018)

© 2018 by the Health Physics Society