Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients
Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients
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DOI：
10.1007/s10549-006-9484-5
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发表时间：
2007-12-01
影响因子：
3.8
通讯作者：
Fehm, Tanja
中科院分区：
文献类型：
--
作者：
Becker, Sven;Solomayer, Erich;Fehm, Tanja
乳腺癌患者骨髓中存在播散性肿瘤细胞已被证明是一个独立的预后因素。本研究的目的是探讨原发性全身治疗后肿瘤细胞播散的状态与therapeutic responsibility.Methods骨髓穿刺120例患者完成后的原发性全身治疗。免疫细胞化学法检测播散的肿瘤细胞。骨髓状态与临床病理因素以及肿瘤对原发性全身治疗的反应相关。结果120例患者中有60例骨髓穿刺液中有播散性肿瘤细胞（50%）。病理完全缓解的缓解率为18%，部分缓解为52%，无变化为28%，进展为3%。尽管完全缓解，但其中36%的患者骨髓呈阳性。部分缓解组阳性率为48%。大约61%的病情稳定的患者骨髓中有播散性肿瘤细胞。低反应组的阳性率明显高于反应组（61%vs.38%，P = 0.1）。结论原发性全身化疗不能完全根除乳腺癌患者骨髓中的播散性肿瘤细胞。持续播散性肿瘤细胞的生物学作用需要进一步研究，以优化当前和未来的治疗策略。
Introduction The presence of disseminated tumor cells in the bone marrow of breast cancer patients has proven to be an independent prognostic factor. The aim of this study was to investigate the status of tumor cell dissemination after primary systemic therapy in relation to therapy response.Methods Bone marrow aspirates were obtained from 120 patients after completion of primary systemic therapy. Disseminated tumor cells were detected by immunocytochemistry using the APAAP method. Bone marrow status was correlated with clinicopathological factors as well as tumor response to primary systemic therapy.Results Sixty out of 120 patients had disseminated tumor cells in their bone marrow aspirates (50%). Response rates were 18% for pathologic complete remission, 52% for partial remission, 28% for no change and 3% for progression. Despite complete remission, 36% of these patients were bone marrow positive. In the partial remission group, the positivity rate was 48%. About 61% of patients with stable disease had disseminated tumor cells in their bone marrow. A trend to higher positivity rates was observed in the poor responder group compared to responders (61% vs. 38%, P = 0.1).Conclusion Primary systemic therapy does not completely eradicate disseminated tumor cells in the bone marrow of breast cancer patients. The biological role of persistent disseminated tumor cells needs to be further investigated to optimize current and future therapeutic strategies.