Heiss M M, Allgayer H, Gruetzner K U, Funke I, Babic R, Jauch K W, Schildberg F W
Department of Surgery, Klinikum Grosshadern, Ludwig Maximilians University of Munich, Germany.
Nat Med. 1995 Oct;1(10):1035-9. doi: 10.1038/nm1095-1035.
It is unclear whether disseminated tumour cells detected in bone marrow in early stages of solid cancers indicate a subclinical systemic disease component determining the patient's fate or simply represent mainly irrelevant shed cells. Moreover, characteristics differentiating high and low metastatic potential of disseminated tumour cells are not defined. We performed repeated serial bone marrow biopsies during follow-up in operated gastric cancer patients. Most patients with later tumour relapse revealed either an increase or a constantly high number of tumour cells. In contrast, in patients without recurrence, either clearance of tumour cells or negative or low cell counts were seen. Urokinase plasminogen activator (uPA)-receptor expression on disseminated tumour cells was significantly correlated with increasing tumour cell counts and clinical prognosis. These results demonstrate a systemic component in early solid cancer, indicated by early systemically disseminated tumour cells, which may predict individual disease development.
目前尚不清楚在实体癌早期骨髓中检测到的播散肿瘤细胞是表明存在决定患者命运的亚临床系统性疾病成分，还是仅仅主要代表无关的脱落细胞。此外，区分播散肿瘤细胞高转移潜能和低转移潜能的特征尚未明确。我们在接受手术的胃癌患者随访期间进行了多次连续骨髓活检。大多数后期肿瘤复发的患者显示肿瘤细胞数量增加或持续处于高位。相比之下，在未复发的患者中，要么肿瘤细胞被清除，要么细胞计数为阴性或较低。播散肿瘤细胞上尿激酶型纤溶酶原激活物（uPA）受体的表达与肿瘤细胞数量增加及临床预后显著相关。这些结果表明早期实体癌存在系统性成分，由早期全身播散的肿瘤细胞所指示，这可能预测个体疾病的发展。
