Circulating tumor cell number and prognosis in progressive castration-resistant prostate cancer
Circulating tumor cell number and prognosis in progressive castration-resistant prostate cancer
复制标题
DOI：
10.1158/1078-0432.ccr-07-1506
复制
发表时间：
2007-12-01
影响因子：
11.5
通讯作者：
Scher, Howard I.
中科院分区：
文献类型：
--
作者：
Danila, Daniel C.;Heller, Glenn;Scher, Howard I.
目的：开发肿瘤特异性标志物以选择靶向治疗和评估临床结果仍然是未满足需求的重要领域。我们评估了基线循环肿瘤细胞（CTC）的数量与临床特征和生存的去势转移性疾病患者考虑不同的激素和细胞毒therapy.Experimental Design. CTC的相关性，从7.5毫升的血液样本中分离出免疫磁性捕获从120名患者进行性临床去势转移性疾病。我们通过Kaplan-Meier方法估计随时间推移的生存概率。的一致性概率估计被用来衡量的歧视强度的信息预后factors.Results：六十九（57%）患者有五个或更多的CTC，而30（25%）有两个细胞或less. Higher CTC数观察到骨转移患者相对于那些与软组织疾病和患者谁曾接受过细胞毒性化疗相对于那些谁没有。CTC计数与肿瘤负荷的测量值（如前列腺特异性抗原和骨扫描指数）适度相关，反映了肿瘤累及骨骼的百分比。基线CTC数与生存率密切相关，没有阈值效应，进一步增加时，基线前列腺特异性抗原和白蛋白included.Conclusions：基线CTC是生存预测，没有阈值效应。细胞脱落到循环中代表肿瘤的固有性质，与疾病的程度不同，并提供与预后相关的独特信息。
Purpose: The development of tumor-specific markers to select targeted therapies and to assess clinical outcome remains a significant area of unmet need. We evaluated the association of baseline circulating tumor cell (CTC) number with clinical characteristics and survival in patients with castrate metastatic disease considered for different hormonal and cytotoxic therapies.Experimental Design: CTC were isolated by immunomagnetic capture from 7.5-mL samples of blood from 120 patients with progressive clinical castrate metastatic disease. We estimated the probability of survival over time by the Kaplan-Meier method. The concordance probability estimate was used to gauge the discriminatory strength of the informative prognostic factors.Results: Sixty-nine (57%) patients had five or more CTC whereas 30 (25%) had two cells or less. Higher CTC numbers were observed in patients with bone metastases relative to those with soft tissue disease and in patients who had received prior cytotoxic chemotherapy relative to those who had not. CTC counts were modestly correlated to measurements of tumor burden such as prostate-specific antigen and bone scan index, reflecting the percentage of boney skeleton involved with tumor. Baseline CTC number was strongly associated with survival, without a threshold effect, which increased further when baseline prostate-specific antigen and albumin were included.Conclusions: Baseline CTC was predictive of survival, with no threshold effect. The shedding Of cells into the circulation represents an intrinsic property of the tumor, distinct from extent of disease, and provides unique information relative to prognosis.