Liu Bo-Lin, Liu Shu-Juan, Baskys Andrius, Cheng Hong, Han Ying, Xie Chao, Song Hui, Li Jia, Xin Xiao-Yan
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, West Changle Road, No,127, Xi'an 710032 Shaanxi Province People's Republic of China.
BMC Cancer. 2014 Nov 17;14:829. doi: 10.1186/1471-2407-14-829.
To characterize prognostic and risk factors of central nervous system (CNS) metastases in patients with epithelial ovarian cancer (EOC).
A retrospective analysis of Xijing Hospital electronic medical records was conducted to identify patients with pathologically confirmed EOC and CNS metastases. In addition to patient demographics, tumor pathology, treatment regimens, and clinical outcomes, we compared putative cancer stem cell marker CD133 expression patterns in primary and metastatic lesions as well as in recurrent EOC with and without CNS metastases.
Among 1366 patients with EOC, metastatic CNS lesions were present in 29 (2.1%) cases. CD133 expression in primary tumor was the only independent risk factor for CNS metastases; whilst the extent of surgical resection of primary EOC and platinum resistance were two independent factors significantly associated with time to CNS metastases. Absence of CD133 expression in primary tumors was significantly associated with high platinum sensitivity in both patient groups with and without CNS metastases. Platinum resistance and CD133 cluster formation in CNS metastases were associated with decreased survival, while multimodal therapy including stereotactic radiosurgery (SRS) for CNS metastases was associated with increased survival following the diagnosis of CNS metastases.
These data suggest that there exist a positive association between CD133 expression in primary EOC, platinum resistance and the increased risk of CNS metastases, as well as a less favorable prognosis of EOC. The absence of CD133 clusters and use of multimodal therapy including SRS could improve the outcome of metastatic lesions. Further investigation is warranted to elucidate the true nature of the association between platinum sensitivity, CD133 expression, and the risk and prognosis of CNS metastases from EOC.
明确上皮性卵巢癌（EOC）患者中枢神经系统（CNS）转移的预后及风险因素。
对西京医院电子病历进行回顾性分析，以确定经病理证实的EOC和CNS转移患者。除患者人口统计学特征、肿瘤病理、治疗方案和临床结局外，我们比较了原发性和转移性病变以及复发性EOC（伴或不伴CNS转移）中假定的癌症干细胞标志物CD133的表达模式。
在1366例EOC患者中，29例（2.1%）出现CNS转移灶。原发性肿瘤中CD133的表达是CNS转移的唯一独立危险因素；而原发性EOC的手术切除范围和铂耐药性是与CNS转移时间显著相关的两个独立因素。原发性肿瘤中CD133表达缺失在伴或不伴CNS转移的患者组中均与高铂敏感性显著相关。CNS转移中的铂耐药性和CD133聚集与生存率降低相关，而包括立体定向放射外科（SRS）治疗CNS转移的多模式治疗与CNS转移诊断后的生存率提高相关。
这些数据表明，原发性EOC中CD133表达、铂耐药性与CNS转移风险增加之间存在正相关，以及EOC的预后较差。CD133聚集的缺失和包括SRS在内的多模式治疗的使用可改善转移性病变的结局。有必要进一步研究以阐明铂敏感性、CD133表达与EOC的CNS转移风险及预后之间关联的真实性质。
