Moreno Jose G, Miller M Craig, Gross Steve, Allard W Jeffrey, Gomella Leonard G, Terstappen Leon W M M
Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Urology. 2005 Apr;65(4):713-8. doi: 10.1016/j.urology.2004.11.006.
To determine whether circulating tumor cells (CTCs) predict for survival in patients with metastatic prostate cancer (PCa) and to compare its prognostic abilities with other clinical factors.
Blood samples from 37 patients with metastatic PCa were analyzed for CTCs. CTCs were enriched from 7.5 mL blood using magnetic nanoparticles targeting the epithelial cell adhesion molecule and then fluorescently labeled. The samples were analyzed by multiparameter flow cytometry, and events with appropriate light scatter properties that were nucleic acid dye positive, cytokeratin positive, and CD45 negative were defined as CTCs.
The number of CTCs found ranged from 0 to 8586 per 7.5 mL (mean 530 +/- 1887, median 5). A threshold of 5 or more CTCs per 7.5 mL of blood was used to evaluate the ability of CTCs to predict for overall survival. Of the 37 patients, 23 (62%) had 5 or more CTCs, with a median overall survival of 0.70 year compared with more than 4 years for those patients with fewer than 5 CTCs (log-rank P = 0.002, Cox hazards ratio 7.4). In the subset of 26 patients with hormone-refractory PCa, the presence of CTCs was the most significant parameter predictive of survival in univariate and multivariate analyses.
In this pilot study, the presence of 5 or more CTCs in 7.5 mL blood was associated with poor overall survival in patients with metastatic PCa.
确定循环肿瘤细胞（CTC）是否可预测转移性前列腺癌（PCa）患者的生存情况，并将其预后能力与其他临床因素进行比较。
对37例转移性PCa患者的血样进行CTC分析。使用靶向上皮细胞粘附分子的磁性纳米颗粒从7.5 mL血液中富集CTC，然后进行荧光标记。通过多参数流式细胞术分析样本，将具有适当光散射特性、核酸染料阳性、细胞角蛋白阳性且CD45阴性的事件定义为CTC。
每7.5 mL血液中发现的CTC数量范围为0至8586个（平均530±1887个，中位数5个）。以每7.5 mL血液中5个或更多CTC为阈值来评估CTC预测总生存的能力。在37例患者中，23例（62%）有5个或更多CTC，其中位总生存期为0.70年，而CTC少于5个的患者中位总生存期超过4年（对数秩检验P = 0.002，Cox风险比7.4）。在26例激素难治性PCa患者亚组中，在单变量和多变量分析中，CTC的存在是生存的最显著预测参数。
在这项初步研究中，7.5 mL血液中存在5个或更多CTC与转移性PCa患者的总生存较差相关。
