Xenidis Nikos, Perraki Maria, Kafousi Maria, Apostolaki Stella, Bolonaki Irene, Stathopoulou Aliki, Kalbakis Kostas, Androulakis Nikos, Kouroussis Charalambos, Pallis Thanos, Christophylakis Charalambos, Argyraki Katerina, Lianidou Evi S, Stathopoulos Stathis, Georgoulias Vassilis, Mavroudis Dimitris
Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece.
J Clin Oncol. 2006 Aug 10;24(23):3756-62. doi: 10.1200/JCO.2005.04.5948. Epub 2006 Jun 12.
To evaluate the predictive and prognostic value of peripheral blood cytokeratin-19 (CK-19) mRNA-positive cells in axillary lymph node-negative breast cancer patients.
Peripheral blood was obtained from 167 node-negative breast cancer patients before the initiation of any systemic adjuvant therapy, and was analyzed for the presence of CK-19 mRNA-positive cells using a real time polymerase chain reaction assay. The association with known prognostic factors and the effect of CK-19 mRNA-positive cells on patients' prognosis was investigated.
CK-19 mRNA-positive cells were detected in the blood of 36 (21.6%) of the 167 patients. There was no correlation between the detection of CK-19 mRNA-positive cells in the peripheral blood and the various known pathologic and clinical prognostic factors; only overexpression of HER2 receptor (score 2+/3+) on the primary tumor was associated with a higher incidence of CK-19 mRNA-positive cell detection (P = .033). Multivariate analysis revealed that detection of peripheral blood CK-19 mRNA-positive cells was associated with early clinical relapse (P < .00001) and disease-related death (P = .008).
Detection of peripheral-blood CK-19 mRNA-positive cells is an independent predictive and prognostic factor for reduced disease-free interval and overall survival, respectively, in node-negative breast cancer patients.
评估外周血细胞角蛋白-19（CK-19）mRNA阳性细胞对腋窝淋巴结阴性乳腺癌患者的预测和预后价值。
在167例淋巴结阴性乳腺癌患者开始任何全身辅助治疗之前采集外周血，采用实时聚合酶链反应分析检测CK-19 mRNA阳性细胞的存在情况。研究其与已知预后因素的相关性以及CK-19 mRNA阳性细胞对患者预后的影响。
167例患者中有36例（21.6%）血液中检测到CK-19 mRNA阳性细胞。外周血中CK-19 mRNA阳性细胞的检测与各种已知的病理和临床预后因素之间无相关性；仅原发肿瘤上HER2受体过表达（评分2+/3+）与CK-19 mRNA阳性细胞检测的较高发生率相关（P = 0.033）。多变量分析显示，外周血CK-19 mRNA阳性细胞的检测与早期临床复发（P < 0.00001）和疾病相关死亡（P = 0.008）相关。
外周血CK-19 mRNA阳性细胞的检测分别是腋窝淋巴结阴性乳腺癌患者无病生存期缩短和总生存期的独立预测和预后因素。
