Characterization of metastatic breast cancer patients with nondetectable circulating tumor cells
Characterization of metastatic breast cancer patients with nondetectable circulating tumor cells
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DOI：
10.1002/ijc.25690
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发表时间：
2011-07-15
影响因子：
6.4
通讯作者：
Cristofanilli, Massimo
中科院分区：
文献类型：
--
作者：
Mego, Michal;De Giorgi, Ugo;Cristofanilli, Massimo
循环肿瘤细胞(CTC)是转移性乳腺癌患者(MBC)的独立预后因素。然而，在三分之一的患者中检测不到CTC。这项研究的目的是评估没有检测到CTC的MBC患者的预后因素。这项回顾性研究包括2004年1月至2007年12月期间评估的292名MBC患者。在患者使用CellSearch(TM)开始新的治疗路线之前，对CTC进行了计数。总生存期(OS)由CTC测量日期计算，并用Kaplan-Meier乘积限值法估计。未检出CTC与脑转移呈正相关(OR：6.17，95%CI 52.14~17.79；P=0.001)，与骨转移呈负相关(OR：0.47；95%CI=0.27~0.80；P=0.01)。在多因素分析中，激素受体、转移部位数目和治疗路线是未检测到CTC的患者OS的独立预后因素。在开始新的治疗前没有检测到CTC的患者组成了一个预后显著不同的异质性组。我们发现，一些重要的转移性疾病特征可以预测MBC中无法检测到的CTC状态。
Circulating tumor cells (CTC) are an independent prognostic factor in metastatic breast cancer patients (MBC). However, CTC are undetectable in one third of patients. The aim of this study was to assess the prognostic factors in MBC patients without detectable CTC. This retrospective study included 292 MBC patients evaluated between January 2004 and December 2007. CTC were enumerated before patients started a new line of treatment using the CellSearch (TM). Overall survival (OS) was calculated from the date of CTC measurement and estimated by the Kaplan-Meier product limit method. CTC were not detected in 35.96% patients, whereas 40.75% patients had CTC >= 5. Undetectable CTC status was positively correlated with presence of brain metastasis (OR: 6.17, 95% CI 5 2.14-17.79; p = 0.001), and inversely correlated with bone metastasis (OR: 0.47; 95% CI = 0.27-0.80; p = 0.01). In multivariate analysis, hormone receptors, number of metastatic sites and lines of therapy were independent prognostic factors for OS in patients without detectable CTC. Patients without detectable CTC before starting of a new line of therapy comprise a heterogeneous group with substantially different prognosis. We showed that some important metastatic disease characteristics are predictive of undetectable CTC status in MBC.