Cytokeratin-positive cells in the bone marrow and survival of patients with stage I, II, or III breast cancer.
Cytokeratin-positive cells in the bone marrow and survival of patients with stage I, II, or III breast cancer.
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DOI：
10.1056/nejm200002243420801
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发表时间：
2000-02-24
影响因子：
158.5
通讯作者：
Schlimok, G
中科院分区：
文献类型：
--
作者：
Braun, S;Pantel, K;Schlimok, G
背景：细胞角蛋白是骨髓上皮癌细胞的特异性标志物。我们评估的影响，细胞角蛋白阳性的微转移在骨髓中的妇女与乳腺cancer.Methods的预后：我们获得了骨髓穿刺液从两个上髂嵴的552例I，II，III期乳腺癌患者进行了完整的切除肿瘤和191例非恶性疾病。标本用单克隆抗体A45-B/B3染色，该抗体可与细胞角蛋白上的抗原结合。中位随访时间为38个月（范围：10至70个月）。主要终点是survival.Results：在191例非恶性疾病对照患者中的2例（1%）和552例乳腺癌患者中的199例（36%）的骨髓标本中检测到细胞角蛋白阳性细胞。骨髓中隐匿性转移细胞的存在与淋巴结转移的存在与否无关（P = 0.13）。随访4年后，骨髓微转移的存在与临床上明显的远处转移和癌症相关原因死亡的发生有关（P
Background: Cytokeratins are specific markers of epithelial cancer cells in bone marrow. We assessed the influence of cytokeratin-positive micrometastases in the bone marrow on the prognosis of women with breast cancer.Methods: We obtained bone marrow aspirates from both upper iliac crests of 552 patients with stage I, II, or III breast cancer who underwent complete resection of the tumor and 191 patients with nonmalignant disease. The specimens were stained with the monoclonal antibody A45-B/B3, which binds to an antigen on cytokeratins. The median follow-up was 38 months (range, 10 to 70). The primary end point was survival.Results: Cytokeratin-positive cells were detected in the bone marrow specimens of 2 of the 191 control patients with nonmalignant conditions (1 percent) and 199 of the 552 patients with breast cancer (36 percent). The presence of occult metastatic cells in bone marrow was unrelated to the presence or absence of lymph-node metastasis (P = 0.13). After four years of follow-up, the presence of micrometastases in bone marrow was associated with the occurrence of clinically overt distant metastasis and death from cancer-related causes (P