Detection of cytokeratin-19 mRNA-positive cells in the peripheral blood and bone marrow of patients with operable breast cancer

作者：Daskalaki A; Agelaki S; Perraki M; Apostolaki S; Xenidis N; Stathopoulos E; Kontopodis E; Hatzidaki D; Mavroudis D; Georgoulias V^*

来源：British Journal of Cancer, 2009, 101(4): 589-597.

DOI：10.1038/sj.bjc.6605183

• breast cancer
• circulating tumour cells
• CK-19
• micrometastasis
• disseminated tumour cells

BACKGROUND: To compare detection rates and evaluate the clinical relevance of cytokeratin-19 (CK-19) mRNA-positive cells in the peripheral blood (circulating tumour cells, CTCs) and bone marrow (disseminated tumour cells; DTCs) of patients with early breast cancer.
METHODS: Paired samples of peripheral blood and bone marrow were obtained from 165 patients with stage I-II breast cancer before the initiation of adjuvant chemotherapy. In 84 patients, paired blood and bone marrow samples were also available after chemotherapy. The detection of CK-19 mRNA-positive CTCs and DTCs was assessed by real-time PCR.
RESULTS: CK-19 mRNA-positive CTCs and DTCs were detected in 55.2 and 57.6% of patients before chemotherapy, respectively. After chemotherapy, CTCs and DTCs were identified in 44 (52.4%) and 43 (51.2%) of the 84 patients, respectively. There was a 93.9% (McNemar; P = 0.344) and 72.6% (McNemar; P = 0.999) concordance between blood and bone marrow samples before and after chemotherapy, respectively. The detection of CK-19 mRNA-positive CTCs or DTCs before chemotherapy was associated with decreased overall survival (P = 0.024 and P = 0.015, respectively). In addition, their simultaneous detection was also associated with an increased incidence of disease-related death and decreased overall survival (P = 0.016).
CONCLUSIONS: The detection of CK-19 mRNA-positive CTCs using reverse transcription-PCR (RT-PCR) both before and after chemotherapy is correlated with the detection of CK-19 mRNA-positive DTCs in patients with early-stage breast cancer. The determination of the CTC status by RT- PCR conveys clinically relevant information that is not inferior to DTC status and, owing to the ease of sampling, warrants further evaluation as a tool for monitoring minimal residual disease. British Journal of Cancer (2009) 101, 589-597. doi: 10.1038/sj.bjc.6605183 www.bjcancer.

• 出版日期2009-8-11