Circulating tumor cells in early lobular versus ductal breast cancer and their associations with prognosis.
Circulating tumor cells in early lobular versus ductal breast cancer and their associations with prognosis.
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早期小叶乳腺癌与导管乳腺癌中的循环肿瘤细胞及其与预后的关系。
DOI：
10.1038/s41523-024-00623-9
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发表时间：
2024
影响因子：
5.9
通讯作者：
Mukhtar,RitaA
中科院分区：
文献类型：
--
作者：
Alkhafaji,Silver;Wolf,DeniseM;Magbanua,MarkJesusM;Jvan'tVeer,Laura;Park,JohnW;Esserman,Laura;Mukhtar,RitaA
这是TIPING研究的次要数据分析，该研究纳入了1，121例I-III期乳腺癌患者，这些患者在1999年至2012年手术切除时进行了CTC计数（通过CellSearch或免疫磁性富集和流式细胞术[IE/FC]）和播散性肿瘤细胞（DTC）。主要终点是按组织学分类的CTC平均数量，考虑到检测方法和治疗类型，以及组织学特异性预后临界点的评价。总体而言，ILC患者的CTC计数显著高于IDC患者，这一发现在采用IE/FC方法进行CTC计数的382例患者中持续存在。此外，在初次手术的患者中，ILC患者的平均CTC计数显著高于IDC患者（分别为平均2.11 CTC/mL和0.71 CTC/mL，p< 0.001），这在多变量分析中持续存在。与CTC-低/DTC-低的患者相比，ILC和CTC-高/DTC-高状态的患者有DRFS降低的趋势（HR = 9.27，95%CI 0.95- 90.5，p = 0.055），BCSS显著降低（HR = 10.4，95%CI 1.07- 99.7，P = 0.043）。在IDC组中，CTC高/DTC高状态与DRFS或BCSS均无关。在新辅助治疗的患者中，ILC组与IDC组的CTC计数无显著差异（分别为平均0.89 CTC/mL与1.06 CTC/mL，p= 0.82）。我们的研究结果有助于有限的文献CTC和DTC在ILC，并建议CTC和DTC检测的临床效用和最佳阈值可能会有所不同的组织学亚型在早期乳腺癌。
This is a secondary data analysis of the TIPPING study, which included 1,121 patients with stage I-III breast cancer who had enumeration of CTCs (by either CellSearch or immunomagnetic enrichment and flow cytometry [IE/FC]) and disseminated tumor cells (DTCs) at the time of surgical resection between 1999 and 2012. The primary endpoint was mean number of CTCs by histology, taking into account method of detection and treatment type, and evaluation of histology specific prognostic cutpoints. Overall, patients with ILC had significantly higher CTC counts than those with IDC, a finding which persisted in the 382 patients with CTC enumeration by IE/FC method. Additionally, among those with primary surgery, patients with ILC had significantly higher mean CTC counts than those with IDC (mean 2.11 CTCs/mL versus 0.71 CTCs/mL respectively,p< 0.001), which persisted on multivariate analysis. Patients with ILC and CTC-high/DTC-high status trended towards reduced DRFS HR = 9.27, 95% CI 0.95–90.5,p= 0.055) and had significantly decreased BCSS (HR = 10.4, 95% CI 1.07–99.7,P= 0.043) compared with those who were CTC-low/DTC-low. In the IDC group, CTC-high/DTC-high status was not associated with either DRFS or BCSS. In neoadjvuantly treated patients, there was no significant difference in CTC counts in the ILC group versus the IDC group (mean 0.89 CTCs/mL versus 1.06 CTCs/mL respectively,p= 0.82). Our findings contribute to the limited literature on CTCs and DTCs in ILC, and suggest that clinical utility and optimal thresholds for CTC and DTC assays may differ by histologic subtype in early-stage breast cancer.