Alix-Panabières Catherine, Müller Volkmar, Pantel Klaus
University Medical Center, Lapeyronie Hospital, Montpellier, France.
Curr Opin Oncol. 2007 Nov;19(6):558-63. doi: 10.1097/CCO.0b013e3282f0ad79.
Current research and clinical developments on hematogeneous micrometastasis in breast cancer patients are summarized.
Distant metastasis is the leading cause of cancer-related death in breast cancer and bone marrow is a common homing organ for blood-borne disseminated tumor cells derived from primary breast carcinomas. Sensitive immunocytochemical or molecular assays now allow the detection of single disseminated tumor cells in bone marrow or the peripheral blood at a frequency of 10 and these cells are detected in 10-60% of breast cancer patients without clinical or even histopathologic signs of metastasis. Recently, evidence has emerged that the detection of disseminated tumor cells and circulating tumor cells may provide important prognostic information, and in particular might help to monitor efficacy of therapy. Moreover, the characterization of disseminated tumor cells/circulating tumor cells has shed new light on the complex process underlying early tumor cell dissemination and metastatic progression in cancer patients.
Research on disseminated tumor cells/circulating tumor cells will help to identify novel targets for biological therapies aimed at preventing metastatic relapse and to monitor the efficacy of these therapies. In particular, understanding tumor dormancy and identifying metastatic stem cells might result in the development of new concepts for antimetastatic therapies.
总结目前关于乳腺癌患者血行微转移的研究及临床进展。
远处转移是乳腺癌患者癌症相关死亡的主要原因,骨髓是原发性乳腺癌血行播散肿瘤细胞常见的归巢器官。灵敏的免疫细胞化学或分子检测方法现已能够检测出骨髓或外周血中单个播散肿瘤细胞,其出现频率为十万分之一,且在10% - 60%无临床甚至组织病理学转移征象的乳腺癌患者中可检测到这些细胞。最近有证据表明,检测播散肿瘤细胞和循环肿瘤细胞可能提供重要的预后信息,尤其有助于监测治疗效果。此外,对播散肿瘤细胞/循环肿瘤细胞的特性分析为癌症患者早期肿瘤细胞播散和转移进展的复杂过程提供了新的认识。
对播散肿瘤细胞/循环肿瘤细胞的研究将有助于确定旨在预防转移复发的生物治疗新靶点,并监测这些治疗的效果。特别是,了解肿瘤休眠和识别转移干细胞可能会催生抗转移治疗的新概念。