Department of Oncology and Radiotherapy, Cancer and Surgery Clinic, OUH, Norwegian Radiumhospital, Pb. Nydalen, Oslo, Norway.
Int J Cancer. 2013 Jul;133(1):149-55. doi: 10.1002/ijc.28002. Epub 2013 Jan 24.
Detection of pretreatment disseminated cells (pre-DTC) reflecting its homing to bone marrow (BM) in prostate cancer (PCa) might improve the current model to predict recurrence or survival in men with nonmetastatic disease despite of primary treatment. Thereby, pre-DTC may serve as an early prognostic biomarker. Post-treatment DTCs (post-DTC) finding may supply the clinician with additional predictive information about the possible course of PCa. To assess the prognostic impact of DTCs in BM aspirates sampled before initiation of primary therapy (pre-DTC) and at least 2 years after (post-DTC) to established prognostic factors and survival in patients with PCa. Available BM of 129 long-term follow-up patients with T1-3N0M0 PCa was assessed in addition to 100 BM of those in whom a pretreatment BM was sampled. Patients received either combined therapy [n = 81 (63%)], radiotherapy (RT) with different duration of hormone treatment (HT) or monotherapy with RT or HT alone [n = 48 (37%)] adapted to the criteria of the SPCG-7 trial. Mononuclear cells were deposited on slides according to the cytospin methodology and DTCs were identified by immunocytochemistry using the pancytokeratin antibodies AE1/AE3. The median age of men at diagnosis was 64.5 years (range 49.5-73.4 years). The median long-term follow-up from first BM sampling to last observation was 11 years. Categorized clinically relevant factors in PCa showed only pre-DTC status as the statistically independent parameter for survival in the multivariate analysis. Pre-DTCs homing to BM are significantly associated with clinically relevant outcome independent to the patient's treatment at diagnosis with nonmetastatic PCa.
检测预处理播散细胞（pre-DTC），反映其归巢骨髓（BM）在前列腺癌（PCa）中可能会改善当前模型，以预测尽管有原发性治疗但仍患有非转移性疾病的男性复发或生存。因此，pre-DTC 可以作为早期预后生物标志物。治疗后播散细胞（post-DTC）的发现可能为临床医生提供关于 PCa 可能病程的额外预测信息。评估在原发性治疗开始前（pre-DTC）和至少 2 年后（post-DTC）采集的 BM 中 DTC 对建立的预后因素和 PCa 患者生存的预后影响。除了 100 例预处理 BM 采样的患者外，还评估了 129 例长期随访 T1-3N0M0 PCa 患者的可用 BM。患者接受了联合治疗[n = 81（63%）]、不同持续时间的激素治疗（HT）的放疗（RT）或单独 RT 或 HT 的单一疗法[ n = 48（37%）]，根据 SPCG-7 试验的标准进行了调整。根据细胞旋转法将单核细胞沉积在载玻片上，并使用泛细胞角蛋白抗体 AE1/AE3 通过免疫细胞化学鉴定 DTC。男性诊断时的中位年龄为 64.5 岁（范围 49.5-73.4 岁）。从第一次 BM 采样到最后一次观察的中位长期随访时间为 11 年。在多变量分析中，分类为有临床意义的 PCa 因素仅显示 pre-DTC 状态是生存的统计学独立参数。pre-DTC 归巢 BM 与有临床意义的结果显著相关，与非转移性 PCa 患者的诊断时治疗无关。
