Prognosis of women with stage IV breast cancer depends on detection of circulating tumor cells rather than disseminated tumor cells
Prognosis of women with stage IV breast cancer depends on detection of circulating tumor cells rather than disseminated tumor cells
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DOI：
10.1093/annonc/mdm507
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发表时间：
2008-03-01
影响因子：
50.5
通讯作者：
Pierga, J. -Y.
中科院分区：
文献类型：
--
作者：
Bidard, F. -C.;Vincent-Salomon, A.;Pierga, J. -Y.
背景：在转移性复发时，检测外周血循环肿瘤细胞（CTC）可预测乳腺癌患者的不良生存。骨髓中弥散性肿瘤细胞（DTC）的检测是早期乳腺癌的独立预后因素。我们评估DTC检测在转移性乳腺癌患者BM中的预后价值。材料和方法：根据ISHAGE分类，使用panytokeratin mAb A45-B/B3筛选来自138例患者的BM抽吸物，以筛查DTC。110例患者（80%）在一线治疗前入组。同时对37例患者进行血液中CTC的筛查。结果：DTC在BM中的检出率为59%。DTC与骨转移相关（P = 0.0001），但与较差的总生存期无关。不良的显著预后因素为激素受体阴性（P = 0.0004）和超过一条化疗线（P = 0.002）。37例转移患者的CTC检测与较短的生存期相关（P = 0.01）。结论：检测CTC而不检测BM DTC对IV期乳腺癌患者的预后有重要意义。血液中的CTC是一种更可靠、侵入性更小的评估预后和监测转移性肿瘤反应的工具。
Background: At metastatic relapse, detection of circulating tumor cells (CTC) in peripheral blood is predictive of poor survival of breast cancer patients. Detection of disseminated tumor cells (DTC) in bone marrow (BM) is an independent prognostic factor in early breast cancer. We evaluated the prognostic value of DTC detection in the BM of metastatic breast cancer patients.Materials and methods: BM aspirates from 138 patients were screened for DTC with the pancytokeratin mAb A45-B/B3, according to the ISHAGE classification. One hundred and ten patients (80%) were enrolled before first-line treatment. Thirty-seven patients were simultaneously screened for CTC in the blood.Results: DTC detection rate in the BM was 59%. DTC were associated with bone metastasis (P = 0.0001), but not with a poorer overall survival. Adverse significant prognostic factors were hormone receptor negativity (P = 0.0004) and more than one line of chemotherapy (P = 0.002). CTC detection in the subgroup of 37 metastatic patients was associated with shorter survival (P = 0.01).Conclusions: Detection of CTC but not BM DTC had a prognostic significance in stage IV breast cancer patients. CTC in blood are a more reliable and a less invasive tool to evaluate prognostic and monitor tumor response in this metastatic setting.