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Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, with approximately 1,000,000
cases reported every year. The fate of circulating tumor cells (CTCs) is an important determinant of metastasis and
recurrence, which lead to most deaths in HCC. Therefore, quantification of CTCs proves to be an emerging tool for
diagnosing, stratifying and monitoring patients with metastatic diseases. In vivo flow cytometry (IVFC) has the
capability to monitor the dynamics of fluorescently labeled CTCs continuously and non-invasively. Here, we combine
IVFC technique and a GFP-transfected HCC orthotopic metastatic tumor model to monitor CTC dynamics. Our IVFC
has ~1.8-fold higher sensitivity than whole blood analysis by conventional flow cytometry. We find out a significant
difference of CTC dynamics between orthotopic and subcutaneous (s.c.) tumor models. We also investigate whether
liver resection promotes or restricts hematogenous metastasis in advanced HCC. Our result shows that the number of
CTCs and early metastases decreases after the resection. CTC dynamics is correlated with tumor growth in our
orthotopic tumor model. The number and size of distant metastases correspond to CTC dynamics. The novel IVFC
technique combined with orthotopic tumor models might provide insights to tumor hematogenous metastasis and
guidance to cancer therapy.
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