Dawood Shaheenah, Cristofanilli Massimo
Department of Breast Medical Oncology, The University of Texas M.D Anderson Cancer Center, Houston, TX 77030, USA.
Curr Treat Options Oncol. 2007 Feb;8(1):89-95. doi: 10.1007/s11864-007-0018-0.
Breast cancer is the most frequent type of cancer in women with major cause of death being metastatic disease. Despite aggressive adjuvant systemic therapy with a variety of novel chemotherapeutic and biologic agents recurrence rates vary widely with current conventional prognostic and predictive markers failing to reliably predict recurrence in either node negative (low risk of recurrence) or node positive (considered to have a high risk of recurrence). The ability to detect the presence of minimal residual disease in various body compartments such as the bone marrow, lymph nodes, and peripheral blood represents a viable alternative. Various methods to detect circulating tumor cells (CTCs) have been described including techniques based on polymerase chain reactions (PCR) and cell enrichment methods. Studies have shown that CTCs in metastatic breast cancer can be used as a marker for overall survival and assessment of therapeutic response. The role of CTCs in early stage breast cancer is less well-established. Large prospective trials are needed to further understand its biology and confirm its role as a predictive and prognostic marker before we can incorporate it into the conventional staging system.
乳腺癌是女性中最常见的癌症类型，主要死因是转移性疾病。尽管采用了多种新型化疗和生物制剂进行积极的辅助全身治疗，但复发率差异很大，目前的传统预后和预测标志物无法可靠地预测淋巴结阴性（复发风险低）或淋巴结阳性（被认为复发风险高）患者的复发情况。检测骨髓、淋巴结和外周血等身体各个部位微小残留病的存在，是一种可行的替代方法。已经描述了多种检测循环肿瘤细胞（CTC）的方法，包括基于聚合酶链反应（PCR）的技术和细胞富集方法。研究表明，转移性乳腺癌中的CTC可作为总生存期和治疗反应评估的标志物。CTC在早期乳腺癌中的作用尚不明确。在将其纳入传统分期系统之前，需要进行大型前瞻性试验，以进一步了解其生物学特性并确认其作为预测和预后标志物的作用。
