Garcia Jorge A, Rosenberg Jonathan E, Weinberg Vivian, Scott Janet, Frohlich Mark, Park John W, Small Eric J
Department of Medicine, University of California-San Francisco, San Francisco, CA, USA.
BJU Int. 2007 Mar;99(3):519-24. doi: 10.1111/j.1464-410X.2007.06659.x.
To determine the feasibility of using flow cytometry fluorescence-activated cell sorting (FACS) analysis for detecting circulating epithelial cells (CECs) in patients with hormone-refractory prostate cancer (HRPC), and to determine whether CECs can be used to predict survival in these patients.
Several prognostic models that include routinely used clinical and laboratory variables for predicting survival in men with HRPC have been reported; the presence of CECs measured by reverse transcriptase-polymerase chain reaction for prostate-specific antigen (PSA) in patients with HRPC is an independent prognostic factor for survival. CECs detected by FACS analysis correlate with advanced stage and poor survival outcome. A retrospective study was conducted to assess the presence of CECs by FACS analysis in metastatic HRPC patients initiating systemic chemotherapy with a taxane-based regimen. The association between clinical variables previously described and the presence of CECs along with the effect of the magnitude of CECs on survival was calculated, in 41 patients with HRPC, all of whom had peripheral blood collected for FACS analysis.
Except for four patients, all those with metastatic HRPC had detectable CECs. Among these patients, the number of CECs/mL was correlated with age, serum PSA level and serum alkaline phosphatase (ALP). Higher serum levels of PSA and ALP predicted a poor survival outcome. Similarly, patients with < or =1.8 CECs/mL had a significantly longer survival than those with more CECs/mL (P = 0.02). With a median follow-up of 15.4 months, the median overall survival for all patients was 18.4 months.
The presence of more CECs in patients with metastatic HRPC was associated with a poorer survival outcome; levels of > or =1.8 CECs/mL were associated with a shorter survival in patients with metastatic HRPC.
确定使用流式细胞术荧光激活细胞分选（FACS）分析检测激素难治性前列腺癌（HRPC）患者循环上皮细胞（CEC）的可行性，并确定CEC是否可用于预测这些患者的生存情况。
已报道了几种用于预测HRPC男性患者生存情况的预后模型，这些模型包括常规使用的临床和实验室变量；HRPC患者中通过逆转录聚合酶链反应检测前列腺特异性抗原（PSA）来测量CEC的存在是生存的独立预后因素。通过FACS分析检测到的CEC与晚期和不良生存结果相关。进行了一项回顾性研究，以通过FACS分析评估开始使用紫杉烷类方案进行全身化疗的转移性HRPC患者中CEC的存在情况。计算了先前描述的临床变量与CEC存在之间的关联以及CEC数量对生存的影响，纳入了41例HRPC患者，所有患者均采集外周血进行FACS分析。
除4例患者外，所有转移性HRPC患者均可检测到CEC。在这些患者中，每毫升CEC数量与年龄、血清PSA水平和血清碱性磷酸酶（ALP）相关。血清PSA和ALP水平较高预示着生存结果较差。同样，每毫升CEC≤1.8的患者的生存期明显长于每毫升CEC更多的患者（P = 0.02）。中位随访15.4个月，所有患者的中位总生存期为18.4个月。
转移性HRPC患者中CEC数量较多与较差的生存结果相关；每毫升CEC≥1.8与转移性HRPC患者较短的生存期相关。
