Department of Obstetrics and Gynecology, Klinikum Traunstein, Cuno-Niggl-Str. 3, 83278, Traunstein, Germany.
J Cancer Res Clin Oncol. 2013 Jun;139(6):1055-62. doi: 10.1007/s00432-013-1418-0. Epub 2013 Mar 23.
The detection of disseminated tumor cells in the bone marrow (DTC-BM) of breast cancer patients is an independent prognostic factor. In recent years, the focus of research was on finding methods for the detection of circulating tumor cells (CTC) in peripheral blood (PB). In this study, we investigated the presence of DTC-BM and CTC by simultaneous examinations in 202 patients at different stages of the disease.
Immunocytochemical examination of DTC-BM (10-20 ml of BM) with the anti-cytokeratin (CK) antibody A45B/B3 followed a standardized protocol. Analysis of PB (7.5 ml) for the presence of CTC was performed with the CellSearch Analyzer system (Veridex, Raritan, NJ, USA).
Overall, DTC-BM were detected in 57/202 (28.2 %, 1->1,000 DTC) and CTC in 41/202 (20.3 %, 1-411 CTC) patients. Congruence of findings was 71.3 % (144/202, p = .002). In 147 pts with primary diagnosis, congruence of results was 69.4 % (102/147). There was no significant correlation between DTC or CTC and the established pathological factors. After a median follow-up time of 34 months (0-82), presence of CTC was borderline significant for tumor-associated death (p = .060). For 41 patients at recurrence-free follow-up, congruence of results was 75.6 % (31/41, p = .018). In this group, there was a patient with both the highest DTC (>1,000) and CTC (411) count, and she presented with distant metastases 3 months later and had died 5 months after that. Of 14 patients with metastatic disease, 9 showed both DTC and CTC (overall congruence 78.6 %, p = .176).
There was significant congruence between DTC and CTC, which even increased in patients at follow-up and in those with metastases. Repeated CTC examinations could be a valuable tool for monitoring patients or the effectiveness of therapies.
检测乳腺癌患者骨髓中的播散肿瘤细胞（DTC-BM）是一个独立的预后因素。近年来，研究的重点是寻找检测外周血（PB）中循环肿瘤细胞（CTC）的方法。在这项研究中，我们通过对 202 名不同疾病阶段患者的同步检查，研究了 DTC-BM 和 CTC 的存在情况。
采用抗细胞角蛋白（CK）抗体 A45B/B3 对 DTC-BM（10-20ml BM）进行免疫细胞化学检查，遵循标准化方案。采用 CellSearch Analyzer 系统（Veridex，Raritan，NJ，USA）分析 PB（7.5ml）中 CTC 的存在情况。
总体而言，202 例患者中 57 例（28.2%，1-1000 个 DTC）检测到 DTC-BM，41 例（20.3%，1-411 个 CTC）检测到 CTC。检测结果的一致性为 71.3%（144/202，p=0.002）。在 147 例初诊患者中，结果的一致性为 69.4%（102/147）。DTC 或 CTC 与既定的病理因素之间没有显著相关性。在中位随访时间为 34 个月（0-82 个月）后，CTC 的存在与肿瘤相关死亡呈临界显著相关（p=0.060）。对于 41 例无复发生存随访患者，检测结果的一致性为 75.6%（31/41，p=0.018）。在这一组中，有一名患者的 DTC（>1000）和 CTC（411）计数均最高，她在 3 个月后出现远处转移，并在 5 个月后死亡。在 14 例转移性疾病患者中，9 例同时存在 DTC 和 CTC（总体一致性为 78.6%，p=0.176）。
DTC 和 CTC 之间存在显著的一致性，这种一致性甚至在随访患者和转移性患者中增加。重复的 CTC 检查可能是监测患者或治疗效果的有价值的工具。
