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Identifier

000382408

Title

Cytoleratin-19 MRNA positive circulating tumor cells during follow-up of patients with operable breast cancer : prognostic significance for pate relapse

Alternative Title

Αξιολόγηση της προγνωστικής σημασίας των κυκλοφορούντων καρκινικών κυττάρων κατά τη διάρκεια παρακολούθησης ασθενών με πρωϊμο καρκίνο μαστού

Author

Σαλούστρος, Εμμανουήλ Σ

Thesis advisor

Μαυρουδής, Δημήτριος

Reviewer

Γεωργούλιας, Βασίλειος
Λιανίδου, Ευρύκλεια

Abstract

Background — the detection of CK-19 mRNA-positive circulating tumor cells (CTC) before and/or after adjuvant chemotherapy in patients with operable breast cancer is associated with poor clinical outcome. Reliable prognostic markers for late disease relapse are not available. In this study we investigated the value of CTC detection during the first 5 years of follow-up in predicting late disease relapse. Patients and Methods — blood was analyzed from 312 women with operable breast cancer who had not experienced disease relapse during the first two years of follow-up. A real-time RT-PCR for CK-19 mRNA was used for CTC detection three months after the completion of adjuvant chemotherapy and every six months thereafter for a 5-year follow-up period. Results — eighty (25.6 percent) patients remained CTC-free throughout the 5-year period. A change in CTC status was observed in 133 (42.6 percent) patients; 64 (20.5 percent) patients with initially CK-19 mRNA-positive CTC during the first 24 months turned CTCnegative afterwards while 69 (22.1 percent) who were initially CTC-negative became CTCpositive. Ninety-nine (31.7 percent) patients remained persistently CK-19 mRNA-positive. After a median follow-up period of 107 months (range: 38-161 months), the persistently CTC-positive patients with either hormonal receptor positive or negative tumors, had a higher risk of late disease relapse compared to the persistently CTC-negative patients (36.4 percent versus 11.2 percent, p&λτ0.001). Multivariate analysis revealed that persistently CTC-positive patients also had a shorter disease-free (p=0.001) and overall survival (p=0.001). Conclusion — persistent detection of CK-19 mRNA-positive CTC during the first 5 years of follow-up is associated with an increased risk of late relapse and death for patients with operable breast cancer, indicating the presence of chemotherapy- and hormonotherapyresistant residual disease. This prognostic evaluation may be useful when deciding on subsequent adjuvant systemic therapy.

Language

Greek

Subject

Breast cancer

CK-19

Circulating tumor cells

Relapse

Καρκίνος μαστού

Κυκλοφορούντα καρκινικά κύτταρα

Κυτταροκερατίνη-19

Υποτροπή

Issue date