Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece.
Br J Cancer. 2012 Jun 5;106(12):1917-25. doi: 10.1038/bjc.2012.202.
To investigate the clinical relevance of CK-19mRNA-positive circulating tumour cells (CTCs) detected before the initiation of front-line treatment in patients with metastatic breast cancer (MBC).
The presence of CTCs was detected in 298 patients with MBC using a real-time PCR (RT-PCR assay. In 44 patients, the detection of CTCs was evaluated by both the CellSearch and the RT-PCR assay. Interaction with known prognostic factors and association of CTCs with clinical outcome were investigated.
There was a strong correlation between the detection of CTCs by both assays. CK-19mRNA-positive CTCs were detected in 201 (67%) patients and their detection was independent of various patients' clinico-pathological characteristics. The median progression-free survival (PFS; 9.2 vs 11.9 months (mo), P=0.003) and the overall survival (OS; 29.7 vs 38.9 mo, P=0.016) were significantly shorter in patients with detectable CK-19mRNA-positive CTCs compared with patients without detectable CTCs. Multivariate analysis demonstrated that oestrogen receptor status, performance status and detection of CTCs were emerged as independent prognostic factors associated with decreased PFS and OS.
The detection of CK-19mRNA-positive CTCs in patients with MBC before front-line therapy could define a subgroup of patients with dismal clinical outcome.
本研究旨在探讨转移性乳腺癌（MBC）患者一线治疗前检测到 CK-19mRNA 阳性循环肿瘤细胞（CTC）的临床相关性。
使用实时 PCR（RT-PCR）检测 298 例 MBC 患者的 CTCs 存在情况。在 44 例患者中，通过 CellSearch 和 RT-PCR 检测 CTCs。研究了 CTCs 与已知预后因素的相互作用以及与临床结局的关系。
两种检测方法均具有很强的相关性。两种检测方法均检测到 201 例（67%）患者存在 CK-19mRNA 阳性 CTCs，其检测与各种患者的临床病理特征无关。与未检测到 CTCs 的患者相比，检测到 CK-19mRNA 阳性 CTCs 的患者中位无进展生存期（PFS；9.2 个月[mo] vs 11.9 mo，P=0.003）和总生存期（OS；29.7 个月 vs 38.9 mo，P=0.016）明显缩短。多变量分析表明，雌激素受体状态、表现状态和 CTCs 的检测是与 PFS 和 OS 降低相关的独立预后因素。
在一线治疗前检测到 MBC 患者 CK-19mRNA 阳性 CTCs 可以确定预后不良的患者亚组。
