Department of Clinical Oncology, Nevada Cancer Institute, Las Vegas, 89135, USA.
Clin Genitourin Cancer. 2011 Sep;9(1):31-8. doi: 10.1016/j.clgc.2011.04.001. Epub 2011 Jun 25.
Little information exists regarding the utility circulating tumor cell (CTC) enumeration in hormone sensitive prostate cancer. We enumerated CTC in 33 consecutive patients undergoing androgren deprivation therapy (ADT) at our institution. Multivariate analysis revealed baseline CTC as the only independent predictor of progression to CRPC. These data suggest that baseline CTC may identify those unlikely to benefit from ADT.
Circulating tumor cell (CTC) enumeration by using the Cellsearch platform has established prognostic and predictive value in patients with metastatic castration-resistant prostate cancer (mCRPC). Limited information exists regarding the clinical utility of CTC enumeration in metastatic hormone-sensitive prostate cancer (mHSPC). The goal of this study was to prospectively determine the relative clinical utility of CTCs in mHSPC.
We analyzed serial CTC in conjunction with other classic biomarkers in 33 consecutive patients treated at the Nevada Cancer Institute with HSPC initiating androgen deprivation therapy and correlated these patients with prognostic prostate-specific antigen (PSA) endpoints and onset of CRPC.
Initial CTC correlated positively with lactate dehydrogenase and alkaline phosphatase, and were unrelated to PSA and testosterone. In univariate analysis, baseline CTC, alkaline phosphatase, lactate dehydrogenase, testosterone, and follow-up CTC were individual predictors of progression to CRPC. In a multivariate Cox regression, only baseline CTC retained independent predictive value. Threshold analysis revealed the cutpoint that optimized specificity and sensitivity of the test to be 3 cells per 7.5 mL whole blood. Baseline CTC also correlated well with PSA nadir benchmarks.
Initial CTC values predict the duration and magnitude of response to hormonal therapy. CTC enumeration may identify patients at risk of progression to CRPC before initiation of androgen deprivation therapy.
利用 Cellsearch 平台进行循环肿瘤细胞 (CTC) 计数在转移性去势抵抗性前列腺癌 (mCRPC) 患者中已确立了预后和预测价值。关于 CTC 计数在转移性激素敏感性前列腺癌 (mHSPC) 中的临床应用价值，相关信息有限。本研究的目的是前瞻性地确定 CTC 在 mHSPC 中的相对临床应用价值。
我们分析了在 Nevada Cancer Institute 接受 HSPC 起始雄激素剥夺治疗的 33 例连续患者的连续 CTC，并将这些患者与预后前列腺特异性抗原 (PSA) 终点和 CRPC 发病相关联。
初始 CTC 与乳酸脱氢酶和碱性磷酸酶呈正相关，与 PSA 和睾酮无关。在单因素分析中，基线 CTC、碱性磷酸酶、乳酸脱氢酶、睾酮和随访 CTC 是进展为 CRPC 的独立预测因素。在多变量 Cox 回归中，只有基线 CTC 保留了独立的预测价值。阈值分析显示，优化测试特异性和灵敏度的截点为每 7.5ml 全血 3 个细胞。基线 CTC 也与 PSA 最低值基准良好相关。
初始 CTC 值可预测激素治疗的持续时间和反应程度。CTC 计数可能在开始去势治疗之前识别出有进展为 CRPC 风险的患者。
