Preoperative detection of peripherally circulating cancer cells and its prognostic significance in ovarian cancer
Preoperative detection of peripherally circulating cancer cells and its prognostic significance in ovarian cancer
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DOI：
10.1016/j.ygyno.2003.08.004
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发表时间：
2003-11-01
影响因子：
4.7
通讯作者：
Carson, LF
中科院分区：
文献类型：
--
作者：
Judson, PL;Geller, MA;Carson, LF
Objective.对几种实体瘤的研究表明，骨髓或外周血中存在隐匿性转移是无病生存率和总生存率降低的高度预测因素。我们的目的是确定在疾病诊断或复发时外周血中循环卵巢或原发性腹膜癌细胞的发生率，并确定这些隐匿性转移的预后意义。术前抽取了91名被认为是新诊断或复发的上皮性卵巢癌或原发性腹膜癌的妇女的外周血。所有样本均进行肿瘤富集免疫细胞化学分析。64名妇女被发现患有上皮性卵巢癌或原发性腹膜癌。在64名患有癌症的女性中，12名在外周血中有循环癌细胞的证据（18.7%）。使用Fisher精确检验或Wilcoxon-Mann-Whitney检验（视情况而定）比较具有循环癌细胞的患者和不具有循环癌细胞的患者的特征。有循环癌细胞的女性比没有循环癌细胞的女性有更多的3级肿瘤。在平均随访18.7个月（SD 6.7个月）时，Kaplan-Meier估计和对数秩检验分析表明，有和无循环癌细胞患者的生存曲线没有差异。卵巢癌和原发性腹膜癌在历史上被认为主要通过直接细胞接种在整个腹腔中传播，可在外周血中具有循环癌细胞。识别循环癌细胞的临床效用尚未确定。(C)2003年爱思唯尔公司All rights reserved.
Objective. Studies in several solid tumors have shown that the presence of occult metastasis in the bone marrow or peripheral blood is highly predictive of decreased disease-free and overall survival. Our objective was to determine the incidence of circulating ovarian or primary peritoneal cancer cells in the peripheral blood at the time of disease diagnosis, or recurrence, and to determine the prognostic significance of these occult metastasis.Methods. Peripheral blood was drawn preoperatively from 91 women thought to have newly diagnosed or recurrent epithelial ovarian or primary peritoneal carcinoma. All samples underwent a tumor-enriched immunocytochemical assay.Results. Sixty-four women were found to have epithelial ovarian or primary peritoneal cancer. Of the 64 women with cancer, 12 had evidence of circulating cancer cells in their peripheral blood (18.7%). Characteristics were compared between those with circulating cancer cells and those without, using Fisher's exact test or the Wilcoxon-Mann-Whitney test, as appropriate. Women with circulating cancer cells had statistically more grade 3 tumors than women without. At a mean follow-up of 18.7 months (SD 6.7 months), analysis using Kaplan-Meier estimation and the log-rank test indicated that survival curves did not differ between patients with and without circulating cancer cells.Conclusion. Ovarian and primary peritoneal cancer, which historically has been thought to spread primarily by direct cell seeding throughout the abdominal cavity, can have circulating cancer cells in the peripheral blood. The clinical utility of identifying circulating cancer cells is yet to be defined. (C) 2003 Elsevier Inc. All rights reserved.