Polyester fabric sheet layers functionalized with graphene oxide for sensitive isolation of circulating tumor cells

The metastasis of cancer is strongly associated with the spread of circulating tumor cells (CTCs). Based on the microfluidic devices, which offer rapid recovery of CTCs, a number of studies have demonstrated the potential of CTCs as a diagnostic tool. However, not only the insufficient specificity and sensitivity derived from the rarity and heterogeneity of CTCs, but also the high-cost fabrication processes limit the use of CTC-based medical devices in commercial. Here, we present a low-cost fabric sheet layers for CTC isolation, which are composed of polyester monofilament yarns. Fabric sheet layers are easily functionalized with graphene oxide (GO), which is beneficial for improving both sensitivity and specificity. The GO modification to the low-cost fabrics enhances the binding of anti-EpCAM antibodies, resulting in 10-25% increase of capture efficiency compared to the surface without GO (anti-EpCAM antibodies directly onto the fabric sheets), while achieving high purity by isolating only 50-300 leukocytes in 1 mL of human blood. We investigated CTCs in ten human blood samples and successfully isolated 4-42 CTCs/mL from cancer patients, while none of cancerous cells were found among healthy donors. This remarkable results show the feasibility of GO-functionalized fabric sheet layers to be used in various CTC-based clinical applications, with high sensitivity and selectivity.