Different Prognostic Value of Cytokeratin-19 mRNA–Positive Circulating Tumor Cells According to Estrogen Receptor and HER2 Status in Early-Stage Breast Cancer
| Autor: | Dimitris Mavroudis, Stella Apostolaki, Grigorios Chlouverakis, Eleni Politaki, Michail Ignatiadis, Evi Lianidou, Maria Kafousi, Efstathios N. Stathopoulos, M. Perraki, Vassilis Georgoulias, Christos Sotiriou, N. Xenidis, Aliki Stathopoulou |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty Pathology Receptor ErbB-2 Estrogen receptor Breast Neoplasms Cytokeratin Circulating tumor cell Breast cancer Internal medicine medicine Humans RNA Messenger Stage (cooking) Aged Neoplasm Staging Keratin-19 business.industry Hazard ratio Cancer Middle Aged Neoplastic Cells Circulating Prognosis medicine.disease Reverse transcriptase Receptors Estrogen Multivariate Analysis Female business |
| Zdroj: | Journal of Clinical Oncology. 25:5194-5202 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose To examine the prognostic value of cytokeratin-19 (CK-19) mRNA–positive circulating tumor cells (CTCs) in early-stage breast cancer patients focusing on clinically relevant subgroups based on estrogen receptor (ER) and HER2 expression. Patients and Methods CK-19 mRNA–positive CTCs were detected by real-time reverse transcriptase polymerase chain reaction in the blood of 444 consecutive, stage I-III, breast cancer patients before initiation of adjuvant chemotherapy. The association between detection of CK-19 mRNA–positive CTCs and clinical outcome was analyzed for patients with ER-positive, ER-negative, triple-negative, HER2-positive, and ER-positive/HER2-negative tumors. Results CK-19 mRNA–positive CTCs were detected in 181 (40.8%) of 444 patients; 109 (41.9%) of 260 patients with ER-positive tumors; 71 (40.6%) of 175 patients with ER-negative tumors; 27 (35%) of 77 patients with triple-negative tumors; 35 (39.8%) of 88 patients with HER2-positive tumors; and 82 (44.1%) of 186 patients with ER-positive/HER2-negative tumors. After a median follow-up of 53.5 months, patients with CK-19 mRNA–positive CTCs experienced reduced disease-free survival (DFS; P < .001) and overall survival (OS; P < .001); this was mainly observed in patients with ER-negative (P < .001 and P < .001, respectively) but not ER-positive tumors (P = .172 and P = .425, respectively) and in patients with triple-negative (P = .008 and P = .001, respectively) and HER2-positive (P = .023 and P = .040, respectively) but not ER-positive/HER2-negative tumors (P = .210 and P = .578, respectively). In multivariate analysis, the interaction between CK-19 mRNA–positive CTCs and ER status was the strongest independent prognostic factor for reduced DFS (hazard ratio [HR], 3.808; 95% CI, 2.415 to 6.003; P < .001) and OS (HR, 4.172; 95% CI, 2.477 to 9.161; P < .001). Conclusion Detection of CK-19 mRNA–positive CTCs before adjuvant chemotherapy predicts poor clinical outcome mainly in patients with ER-negative, triple-negative, and HER2-positive early-stage breast cancer. |
| Databáze: | OpenAIRE |
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