Thalgott M, Heck M M, Pantel K
Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland,
Urologe A. 2014 Apr;53(4):509-13. doi: 10.1007/s00120-014-3444-1.
Circulating tumor cells (CTCs) can be detected with sensitive immunocytological and molecular methods and can potentially cause distant metastases. Consecutively the prognostic significance of CTC-counts for survival was demonstrated in metastatic prostate cancer (mPC) revealing CTCs as reliable surrogate marker during therapy. Comparatively the prognostic value of a CTC-threshold with < 5 vs. ≥ 5 CTCs was superior to the commonly used PSA-decrement algorithms. In contrast despite evidence of CTCs in localized PC, their clinical value in this stage is currently precarious. Furthermore, CTCs may serve as predictive markers with the ability to predict treatment sensitivity or resistance, since they may represent the heterogeneous molecular signature of primary as well as metastatic cancer lesions. Thus, the isolation of CTCs may serve not only as a prognostic tool but moreover as a liquid biopsy and a window towards personalized treatment. This review discusses the clinical impact of CTCs in the different stages of PC.
循环肿瘤细胞(CTCs)可用灵敏的免疫细胞和分子方法检测到,并且有可能引发远处转移。连续地,循环肿瘤细胞计数对转移性前列腺癌(mPC)生存的预后意义得到了证实,这表明循环肿瘤细胞在治疗期间是可靠的替代标志物。相比之下,循环肿瘤细胞阈值<5个与≥5个的预后价值优于常用的前列腺特异抗原(PSA)下降算法。相反,尽管在局限性前列腺癌中存在循环肿瘤细胞的证据,但它们在这个阶段的临床价值目前尚不稳定。此外,循环肿瘤细胞可作为预测标志物,具有预测治疗敏感性或耐药性的能力,因为它们可能代表原发性以及转移性癌灶的异质分子特征。因此,循环肿瘤细胞的分离不仅可作为一种预后工具,而且还可作为液体活检以及通向个性化治疗的窗口。本综述讨论了循环肿瘤细胞在前列腺癌不同阶段的临床影响。