Translational Cancer Research Group (Laboratory of Pathology, University of Antwerp/University Hospital Antwerp, Oncology Centre, General Hospital Sint-Augustinus), Antwerp, Belgium.
Br J Cancer. 2010 Jan 19;102(2):276-84. doi: 10.1038/sj.bjc.6605472. Epub 2009 Dec 1.
The detection, enumeration and isolation of circulating tumour cells (CTCs) have considerable potential to influence the clinical management of patients with breast cancer. There is, however, substantial variability in the rates of positive samples using existing detection techniques. The lack of standardisation of technology hampers the implementation of CTC measurement in clinical routine practice.
This study was designed to directly compare three techniques for detecting CTCs in blood samples taken from 76 patients with metastatic breast cancer (MBC) and from 20 healthy controls: the CellSearch CTC System, the AdnaTest Breast Cancer Select/Detect and a previously developed real-time qRT-PCR assay for the detection of CK-19 and mammaglobin transcripts.
As a result, 36% of patients with MBC were positive by the CellSearch System, 22% by the AdnaTest, 26% using RT-PCR for CK-19 and 54% using RT-PCR for mammaglobin. Samples were significantly more likely to be positive for at least one mRNA marker using RT-PCR than using the CellSearch System (P=0.001) or the AdnaTest (P<0.001).
We observed a substantial variation in the detection rates of CTCs in blood from breast cancer patients using three different techniques. A higher rate of positive samples was observed using a combined qRT-PCR approach for CK-19 and mammaglobin, which suggests that this is currently the most sensitive technique for detecting CTCs.
循环肿瘤细胞（CTC）的检测、计数和分离在很大程度上有可能影响乳腺癌患者的临床管理。然而，使用现有检测技术的阳性样本率存在很大差异。技术缺乏标准化阻碍了 CTC 测量在临床常规实践中的实施。
本研究旨在直接比较三种技术在 76 例转移性乳腺癌（MBC）患者和 20 例健康对照者的血液样本中检测 CTCs：CellSearch CTC 系统、AdnaTest Breast Cancer Select/Detect 和之前开发的用于检测 CK-19 和乳球蛋白转录本的实时 qRT-PCR 检测方法。
结果，CellSearch 系统检测到 36%的 MBC 患者阳性，AdnaTest 检测到 22%，CK-19 的 RT-PCR 检测到 26%，乳球蛋白的 RT-PCR 检测到 54%。使用 RT-PCR 检测至少一种 mRNA 标志物的样本阳性率明显高于使用 CellSearch 系统（P=0.001）或 AdnaTest（P<0.001）。
我们观察到使用三种不同技术在血液中检测乳腺癌患者 CTC 的检测率存在很大差异。使用 CK-19 和乳球蛋白的联合 qRT-PCR 方法观察到更高的阳性样本率，这表明这是目前检测 CTC 最敏感的技术。
