Engel H, Kleespies C, Friedrich J, Breidenbach M, Kallenborn A, Schöndorf T, Kolhagen H, Mallmann P
Department of Gynaecology and Obstetrics, University of Cologne, Germany.
Br J Cancer. 1999 Dec;81(7):1165-73. doi: 10.1038/sj.bjc.6690825.
Detection of micrometastases in patients with solid tumours may aid the establishment of prognosis and development of new therapeutic approaches. This study was designed to investigate the presence and frequency of tumour cells in the peripheral blood (PB) of patients with breast or ovarian cancer by using a combination of magnetic activated cell sorting (MACS) and fluorescence in situ hybridization (FISH). Separated tumour cell and PB-samples from 48 patients (35 breast cancers, 12 ovarian tumours, one uterine sarcoma) were analysed for the presence of numerical aberrations of chromosomes 7, 12, 17 and 17 q11.2-q12. Twenty-five patients had primary disease and 23 had relapsed. The technique allows the detection of one tumour cell in 106 normal cells. Circulating tumour cells were detected in 35/48 cases (17 patients had relapsed and 13 primary carcinoma with lymph node or solid metastases) by the expression of anti-cytokeratin and the presence of numerical chromosomal abnormalities. PB-tumour cells of patients with a primary carcinoma and without solid metastases had a significantly lower percentage of chromosomal aberrations, especially for chromosome 12 (P = 0.035; P = 0.038) compared to those with relapsed disease and solid metastases. Detection and quantification of minimal residual disease may monitor the response to cytotoxic or hormonal therapy and may identify women at risk of relapse.
检测实体瘤患者的微转移可能有助于判断预后并开发新的治疗方法。本研究旨在通过联合应用磁性激活细胞分选(MACS)和荧光原位杂交(FISH)技术,调查乳腺癌或卵巢癌患者外周血(PB)中肿瘤细胞的存在情况及频率。对48例患者(35例乳腺癌、12例卵巢肿瘤、1例子宫肉瘤)分离出的肿瘤细胞和PB样本进行分析,检测染色体7、12、17及17q11.2 - q12的数目异常情况。25例患者为原发性疾病,23例为复发患者。该技术能够在106个正常细胞中检测出1个肿瘤细胞。通过抗细胞角蛋白的表达及染色体数目异常情况,在48例中的35例检测到循环肿瘤细胞(17例复发患者,13例伴有淋巴结或实体转移的原发性癌患者)。与复发疾病及有实体转移的患者相比,原发性癌且无实体转移患者的PB肿瘤细胞染色体畸变率显著更低,尤其是染色体12(P = 0.035;P = 0.038)。检测和定量微小残留病可监测细胞毒性或激素治疗的反应,并可识别有复发风险的女性。