Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
In Vivo. 2019 Sep-Oct;33(5):1615-1620. doi: 10.21873/invivo.11645.
To evaluate the clinical efficacy of a circulating tumor cell (CTC) test by comparison between healthy volunteers and patients with localized prostate cancer including those under active surveillance.
CTC counts in peripheral blood were compared between patients with prostate cancer (n=45) and healthy volunteers (n=17). CTCs were identified based on the expression of epithelial cell adhesion molecule (EpCAM) and counted using a SMART BIOPSY™ SYSTEM.
The number of EpCAM+ cells was significantly higher in patients with cancer than in healthy volunteers. Among the low-risk patients (n=9), two had up-staging and six had up-grading. Among those up-staged, there was one case which was EpCAM Among those cases up-graded, three were EpCAM In those with stage T2 tumors, the presence of Gleason pattern 5 was positively correlated with EpCAM positivity (rho=0.59, p<0.001).
CTC counts in localized prostate cancer were associated with Gleason pattern 5. Active treatment should be considered for patients with low-risk disease during active surveillance who are found to have EpCAM+ CTCs because of a risk of up-staging and up-grading.
通过比较局限性前列腺癌患者（包括主动监测患者）与健康志愿者，评估循环肿瘤细胞（CTC）检测的临床疗效。
对比了 45 例前列腺癌患者和 17 例健康志愿者外周血中的 CTC 计数。CTC 通过上皮细胞黏附分子（EpCAM）的表达进行鉴定，并使用 SMART BIOPSY™ SYSTEM 进行计数。
癌症患者 EpCAM+细胞数量明显高于健康志愿者。在低危患者（n=9）中，2 例升期，6 例升级。在升期的病例中，有 1 例 EpCAM 阳性。在升级的病例中，有 3 例 EpCAM 阳性。在 T2 期肿瘤中，Gleason 模式 5 的存在与 EpCAM 阳性呈正相关（rho=0.59，p<0.001）。
局限性前列腺癌的 CTC 计数与 Gleason 模式 5 相关。在主动监测中发现 EpCAM+CTC 的低危疾病患者，由于存在升期和升级的风险，应考虑进行积极治疗。
