Circulating tumor cells in gynaecological malignancies

New non-invasive approaches have developed for diagnosis and treatment of malignant diseases. Cells shed from the primary tumor circulating in the bloodstream with metastasis potential are called Circulating Tumor Cells (CTCs). These cells are easily acquired from the peripheral blood of patients, while several enrichment and isolation methods are available nowadays with different benefits and positive detection rates. A brief characterization of three major categories of detection is described (nucleic acid-based, physical properties-based, antibody-based). In this review we concentrate on gynecological malignancies and how CTCs could be used in the diagnosis of cancer, treatment management and its effective prognosis and early recurrence detection. Presence of CTCs in endometrial cancer patients show worse overall survival, while gene analysis could identify patients in need of systemic therapy after surgical treatment to prevent metastasis and recurrence. Based on the influence of human papillomavirus (HPV) in the etiology of cervical cancer, viral oncogene transcripts could be used as an ideal marker for cervical cancer cells detection. In ovarian cancer, CTCs could help in the differentiation from benign adnexal masses and show a high independence from other biomarkers such as CA125 and HE4. While detection of CTC after complete cytoreductive surgery could indicate invisible lesions, combination of tumor associated genes rises the specificity of CTC detection.