Murray Nigel P, Reyes Eduardo, Orellana Nelson, Fuentealba Cynthia, Dueñas Ricardo
Division of Medicine. Hospital de Carabineros de Chile. Nunoa. Santiago. Chile. Instituto de Bio-Oncología. Providencia. Santiago. Chile.Circulating Tumor Cell Unit. Faculty of Medicine. Universidad Mayor. Las Condes. Santiago. Chile.
Arch Esp Urol. 2014 Oct;67(8):684-91.
Primary CPCs are those detected in the blood of prostate cancer patients before radical treatment; secondary CPCs are those detected afterwards. Although primary CPCs are frequently found, it has been suggested that only a few will survive and go on to form metastasis. We evaluate the frequency of primary and secondary CPC detection and the association with biochemical failure, relation with clinical-pathological parameters and clinical implications in men treated by radical prostatectomy (RP) for prostate cancer.
Serial blood samples were taken before surgery and during follow up after RP. Mononuclear cells were obtained by differential gel centrifugation, and CPCs were identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, non organ confined), pathological grade, margin status (positive, negative), extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative) were compared with the presence/absence of CPCs in patients with and without biochemical failure. Kaplan Meier method was used to compare the unadjusted biochemical failure free survival of patients with and without CPCs.
138 of 423 (32.6%) men undergoing prostate biopsy for an elevated serum PSA were diagnosed of prostate cancer. Of these men 15 (10.9%) were CPC negative. 95 CPC positive men underwent RP. There was no relation between primary CPC detection and clinical-pathological parameters; however, secondary CPCs were associated both with clinical-pathological parameters and biochemical failure.
Primary CPCs are frequently detected in men with prostate cancer, but they are not associated with biochemical failure, so that they may be useful for prostate cancer detection but not for prognosis. The persistence of CPCs after surgery is associated with increased biochemical failure.
原发性循环肿瘤细胞（CPCs）是在前列腺癌患者接受根治性治疗前血液中检测到的细胞；继发性CPCs是在根治性治疗后检测到的细胞。尽管经常能检测到原发性CPCs，但有人认为只有少数会存活并继续形成转移灶。我们评估了原发性和继发性CPCs检测的频率及其与生化复发的关联、与临床病理参数的关系以及在接受前列腺癌根治术（RP）治疗的男性中的临床意义。
在手术前和RP术后随访期间采集系列血样。通过密度梯度离心获得单核细胞，使用抗PSA单克隆抗体通过标准免疫细胞化学鉴定CPCs。将年龄、病理分期（器官局限性、非器官局限性）、病理分级、切缘状态（阳性、阴性）、包膜外侵犯、神经周围、血管和淋巴浸润（阳性、阴性）与有或无生化复发患者中CPCs的存在与否进行比较。采用Kaplan-Meier方法比较有或无CPCs患者未经调整的无生化复发生存率。
423例因血清PSA升高接受前列腺活检的男性中，138例（32.6%）被诊断为前列腺癌。其中15例（10.9%）CPCs为阴性。95例CPCs阳性的男性接受了RP。原发性CPCs检测与临床病理参数之间无关联；然而，继发性CPCs与临床病理参数和生化复发均相关。
前列腺癌男性中经常检测到原发性CPCs，但它们与生化复发无关，因此它们可能对前列腺癌检测有用，但对预后无用。手术后CPCs的持续存在与生化复发增加相关。
