Determining circulating endothelial cells using CellSearch system during preoperative systemic chemotherapy in breast cancer patients

作者：Ali Arwa M; Ueno Takayuki^*; Tanaka Sunao; Takada Masahiro; Ishiguro Hiroshi; Abdellah Ashraf Z; Toi Masakazu

来源：European Journal of Cancer, 2011, 47(15): 2265-2272.

DOI：10.1016/j.ejca.2011.06.015

• Circulating endothelial cells
• CellSearch system
• Breast cancer
• Chemotherapy
• Pathological response

Background: Circulating endothelial cells (CECs) have been studied as a biomarker for tumour progression and monitoring therapeutic effects. The CellSearch system is a semi-automated system that allows standardised analysis of CECs. This study assessed the clinical implications of CECs determined by the CellSearch system in breast cancer patients.
Methods: Seventy-six consecutive breast cancer patients (53 operable and 23 metastatic or recurrent) were enrolled for the study. Thirty-five patients with operable breast cancer received preoperative chemotherapy with a regimen based on anthracycline and/or taxane. CECs are defined as CD146(+)CD105(+)CD45(-)DAPI(+) cells in the system. CD34 expression was examined using the additional channel in the system.
Results: A majority (4539 of 5183 cells, 88%) of CECs from patients with operable breast cancer were CD34-positive. Triple-negative cancers showed higher baseline CEC and CD34(+)CEC counts than the other types (P = 0.0387 and 0.0377, respectively). Low baseline CEC and CD34(+)CEC counts, and a low CD34 positive rate were associated with pathological complete response (pCR) of preoperative chemotherapy in patients with primary breast cancer (P = 0.046, 0.027 and 0.01, respectively). In multivariate analyses, the CD34 positive rate was significant for pCR (P = 0.021). During preoperative chemotherapy; CEC and CD34(+)CEC counts before each cycle of chemotherapy increased with taxane-based regimens (P = 0.0018 and 0.0008, respectively) but not with anthracycline-based regimens.
Conclusions: Baseline CEC, in particular CD34(+)CEC, counts and the CD34 positive rate might be useful for the prediction of treatment response of preoperative chemotherapy in patients with operable breast cancer.

• 出版日期2011-10