Berg Arne, Bruland Øyvind S, Fosså Sophie D, Nesland Jahn M, Berner Aasmund, Schirmer Cecilie, Lilleby Wolfgang
Norwegian Radium Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway.
Prostate. 2008 Nov 1;68(15):1607-14. doi: 10.1002/pros.20826.
The purpose of this study was to explore the prevalence of disseminated tumor cells (DTCs) in bone marrow (BM) of clinically progression-free prostate cancer (PC) patients at least 2 years after curatively intended radiotherapy (RT) with or without adjuvant hormone treatment.
All patients were T(1-3)N(0)M(0) with intermediate or high risk of progression. Median time from RT to BM sampling was 5 years (2-8). A standardized immunocytochemical method applying the anticytokeratin antibodies AE1/AE3 was used for DTCs detection in 130 patients. Morphological characterization of immunostained cells was performed to exclude false positive cells. The post-treatment BM was explored in relation to pre-treatment risk factors, treatment strategy and serum levels of Testosterone and PSA at the time of BM sampling. Longitudinal changes in BM status were studied in a sub-group of 109 patients who also had donated BM prior to treatment.
Post-treatment BM-aspirates were positive for DTCs in 17% of cases without correlation to any of the tested variables. Out of 14 patients who had DTCs in BM prior to treatment, all but one had become post-treatment negative. Out of 95 patients with pre-treatment negative BM status, 18 (19%) had become post-treatment positive.
DTCs in BM were found in 17% of clinically progression-free PC patients following RT. The detection of these cells may provide PSA-independent prognostic information remaining to be explored by prolonged follow-up.
本研究旨在探讨在接受根治性放疗（RT）且有或无辅助激素治疗后至少2年的临床无进展前列腺癌（PC）患者的骨髓（BM）中播散肿瘤细胞（DTCs）的患病率。
所有患者均为T(1 - 3)N(0)M(0)，具有进展的中高危风险。从放疗到骨髓采样的中位时间为5年（2 - 8年）。应用抗细胞角蛋白抗体AE1/AE3的标准化免疫细胞化学方法用于检测130例患者的DTCs。对免疫染色细胞进行形态学特征分析以排除假阳性细胞。研究治疗后骨髓与治疗前危险因素、治疗策略以及骨髓采样时睾酮和前列腺特异性抗原（PSA）的血清水平之间的关系。在109例治疗前也捐献过骨髓的患者亚组中研究骨髓状态的纵向变化。
治疗后骨髓穿刺液中17%的病例DTCs呈阳性，与任何测试变量均无相关性。在治疗前骨髓中有DTCs的14例患者中，除1例之外其余患者治疗后均转为阴性。在95例治疗前骨髓状态为阴性的患者中，18例（19%）治疗后转为阳性。
放疗后17%的临床无进展PC患者骨髓中发现了DTCs。这些细胞的检测可能提供独立于PSA的预后信息，有待通过延长随访进行探索。
