循环肿瘤细胞在转移性乳腺小叶癌与乳腺导管癌中的分布不同-长期预后意义。

The Distribution of Circulating Tumor Cells Is Different in Metastatic Lobular Compared to Ductal Carcinoma of the Breast-Long-Term Prognostic Significance.

机构信息

Department of Clinical Sciences, Division of Oncology, Lund University, SE-223 81 Lund, Sweden.

Department of Oncology, Växjö Central Hospital, SE-352 34 Växjö, Sweden.

出版信息

Cells. 2020 Jul 17;9(7):1718. doi: 10.3390/cells9071718.

BACKGROUND

Invasive lobular carcinoma (ILC) has distinguishing features when compared to invasive ductal carcinoma of no special type (NST). In this study, we explored the distributional and prognostic characteristics of circulating tumor cells (CTCs) in metastatic ILC and NST.

MATERIALS AND METHODS

Patients were included in an observational trial (ClinicalTrials.gov NCT01322893) with ILC ( = 28) and NST ( = 111). CTC count (number/7.5 mL blood) was evaluated with serial sampling (CellSearch). The primary endpoint was progression-free survival (PFS).

RESULTS

The CTC counts were higher in ILC (median 70) than in NST cases (median 2) at baseline ( < 0.001). The evidence for ≥5 CTCs as a prognostic factor for PFS in ILC was weak, but stronger with higher cut-offs (CTC ≥ 20: hazard ratio (HR) 3.0, = 0.01) (CTC ≥ 80: HR 3.6, = 0.004). In NST, however, the prognostic effect of CTCs ≥5 was strong. Decline in CTC count from baseline to three months was associated with improved prognosis in ILC and NST.

CONCLUSIONS

The number of CTCs is higher in ILC than in NST, implying that a higher CTC cut-off could be considered for ILC when applying the CellSearch technique.

背景

与非特殊型浸润性导管癌（NST）相比，浸润性小叶癌（ILC）具有独特的特征。本研究旨在探讨转移性 ILC 和 NST 中循环肿瘤细胞（CTC）的分布和预后特征。

材料和方法

本研究共纳入一项观察性试验（ClinicalTrials.gov NCT01322893）中的 ILC 患者（ = 28）和 NST 患者（ = 111）。采用连续采样（CellSearch）评估 CTC 计数（每 7.5mL 血液中的数量）。主要终点为无进展生存期（PFS）。

结果

基线时，ILC 患者的 CTC 计数（中位数 70）高于 NST 患者（中位数 2）（<0.001）。≥5 CTC 作为 ILC 患者 PFS 的预后因素的证据较弱，但更高的截断值（CTC≥20：风险比（HR）3.0，=0.01）（CTC≥80：HR 3.6，=0.004）则更强。然而，在 NST 中，CTC≥5 的预后效应更强。基线至三个月 CTC 计数的下降与 ILC 和 NST 的预后改善相关。