新功能、新界面、新体验,扫描即可下载生物谷APP!
首页 » 生物研究 » JNCI:血液循环肿瘤细胞预示早期乳腺癌预后

JNCI:血液循环肿瘤细胞预示早期乳腺癌预后

来源:生物谷 2014-05-18 14:43

2014年5月18日讯 /生物谷BIOON/--早期乳腺癌患者骨髓中的肿瘤细胞能预测复发风险较高和预后较差,但骨髓活检是一种创伤性和痛苦的过程。现在发表在5月15日Journal of the National Cancer Institute杂志上研究揭示:识别血液样本的肿瘤细胞,也可作为预后指标。

为了评估早期乳腺癌患者循环肿瘤细胞(CTCs)的预后价值,Brigitte Rack学博士和同事分析SUCCESS临床试验患者外周血中的CTCs。收集2026名患者初次手术后,但在全身治疗前的样本,以及1492例化疗后患者样本。

患者被分为四组:治疗前后CTCs均为阳性;之前和之后CTCs均为阴性;之前呈阳性,但治疗之后为阴性;治疗之前CTCs为阴性,但治疗后为阳性。研究发现与其他三组相比,那些治疗之前和之后CTCs为阳性的患者,有最坏的无病存活。此外,CTC计数更大,预后越差。患者30毫升血液中有5个或更多CTCs,疾病复发的风险较高。

作者得出结论:我们的数据为临床使用CTCs来评估患者预后提供潜在支持证据。不过,他们指出,虽然他们只使用两个标记物来检测CTCs,但其他标志物的鉴定可以使得CTCs更加可能用于预测转移和指导治疗选择。(生物谷Bioon.com)

 

 

Circulating Tumor Cells Predict Survival in Early Average-to-High Risk Breast Cancer Patients

B. Rack, C. Schindlbeck, J. Juckstock, U. Andergassen, P. Hepp, T. Zwingers, T. W. P. Friedl, R. Lorenz, H. Tesch, P. A. Fasching, T. Fehm, A. Schneeweiss, W. Lichtenegger, M. W. Beckmann, K. Friese, K. Pantel, W. Janni.

Background Circulating tumor cells (CTCs) have been shown to predict reduced survival outcomes in metastatic breast cancer.

Methods CTCs were analyzed in 2026 patients with early breast cancer before adjuvant chemotherapy and in 1492 patients after chemotherapy using the CellSearch System. After immuno-magnetic enrichment for cells expressing the epithelial-cell adhesion molecule, CTCs were defined as nucleated cells expressing cytokeratin and lacking CD45. The patients were followed for a median of 35 months (range = 0–54). Kaplan–Meier analyses and the log-rank test were used for survival analyses. All statistical tests were two-sided.

Results Before chemotherapy, CTCs were detected in 21.5% of patients (n = 435 of 2026), with 19.6% (n = 136 of 692) of node-negative and 22.4% (n = 299 of 1334) of node-positive patients showing CTCs (P < .001). No association was found with tumor size, grading, or hormone receptor status. After chemotherapy, 22.1% of patients (n = 330 of 1493) were CTC positive. The presence of CTCs was associated with poor disease-free survival (DFS; P < .0001), distant DFS (P < .001), breast cancer-specific survival (P = .008), and overall survival (OS; P = .0002). CTCs were confirmed as independent prognostic markers in multivariable analysis for DFS (hazard ratio [HR] = 2.11; 95% confidence interval [CI] = 1.49 to 2.99; P < .0001) and OS (HR = 2.18; 95% CI = 1.32 to 3.59; P = .002). The prognosis was worst in patients with at least five CTCs per 30mL blood (DFS: HR = 4.51, 95% CI = 2.59 to 7.86; OS: HR = 3.60, 95% CI = 1.56 to 8.45). The presence of persisting CTCs after chemotherapy showed a negative influence on DFS (HR = 1.12; 95% CI = 1.02 to 1.25; P = .02) and on OS (HR = 1.16; 95% CI = 0.99 to 1.37; P = .06)

Conclusions These results suggest the independent prognostic relevance of CTCs both before and after adjuvant chemotherapy in a large prospective trial of patients with primary breast cancer.

温馨提示:87%用户都在生物谷APP上阅读,扫描立刻下载! 天天精彩!


相关标签

最新会议 培训班 期刊库