The predictive potential of molecular detection in the nonmetastatic Ewing family of tumors
The predictive potential of molecular detection in the nonmetastatic Ewing family of tumors
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DOI：
10.1002/cncr.20059
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发表时间：
2004-03-01
期刊：
影响因子：
6.2
通讯作者：
Yaniv, I
中科院分区：
文献类型：
--
作者：
Avigad, S;Cohen, IJ;Yaniv, I
背景。尤因家族肿瘤（EFTs）是儿童和青少年中第二常见的骨肿瘤。尽管有积极的化疗，三分之一的局部肿瘤患者仍可能复发。这意味着不是所有的肿瘤细胞都被根除，病人可能有一定程度的残留疾病。eft的特点是特定的染色体易位导致嵌合转录物，可以用逆转录-聚合酶链反应（RT-PCR）分析检测。作者报告了26例EFT患者在长时间随访（中位为61个月）期间骨髓（BM）和/或外周血（PBL）中阳性嵌合转录物（EWS/FLI1）的预后潜力。诊断时，43%的患者RT-PCR阳性，与肿瘤进展无相关性（P = 0.3）。在随访期间，58%的患者在最后一次分析样本（BM和/或PBL）中有RT-PCR阳性结果。嵌合转录物的存在与疾病进展之间存在高度显著的相关性（P = 0.0028）。在多因素分析中，肿瘤坏死百分比（P = 0.007）和随访期间的RT-PCR结果（P = 0.02）仍然是重要的预后指标。在11例出现疾病进展的患者中，有10例患者的BM和/或PBL样本嵌合转录物呈阳性，然后才有明显的临床复发证据。长期随访期间BM和/或PBL样本中的隐匿肿瘤细胞是非转移性eft患者疾病复发的有力预测因子。(C) 2004年美国癌症协会。
BACKGROUND. Tumors in the Ewing family (EFTs) are the second most common bone tumors in children and adolescents. Despite aggressive chemotherapy, one-third of patients with localized tumor still may develop recurrences. This implies that not all tumor cells are eradicated and that the patients may have a level of residual disease. EFTs are characterized by specific chromosomal translocations that result in chimeric transcripts that can be detected with reverse transcriptase-polymerase chain reaction (RT-PCR) analysis.METHODS. The authors report the prognostic potential of the positive chimeric transcript (EWS/FLI1) in bone marrow (BM) and/or peripheral blood (PBL) in 26 patients with EFT during a long follow-up period (median, 61 months).RESULTS. At diagnosis, 43% of patients had positive RT-PCR BM results, with no correlation to tumor progression (P = 0.3). During follow-up, 58% of patients had positive RT-PCR results in their last sample analyzed (BM and/or PBL). A highly significant correlation between the presence of the chimeric transcript and disease progression was detected (P = 0.0028). In a multivariate analysis, the percentage of tumor necrosis (P = 0.007) and RT-PCR results during follow-up (P = 0.02) remained significant prognostic markers. In 10 of 11 patients who developed disease progression, BM and/or PBL samples were positive for the chimeric transcript before evidence of overt clinical recurrence.CONCLUSIONS. Occult tumor cells in BM and/or PBL samples during long follow-up are strong predictors of recurrent disease in patients with nonmetastatic EFTs. (C) 2004 American Cancer Society.