驗血可救乳癌患者?

美國德州大學安德森癌症中心(MD Anderson Cancer Center)的研究人員今天(6日)指出， 只要透過簡單的驗血程序， 就可以幫助醫生快速的診斷出罹患早期乳癌的患者是否面臨危亡的高 危險，或者治療後可能復發。

這個研究小組的報告，發表在最新一期的刺胳針腫瘤學期刊( Lancet Oncology)中。

報告指出，在乳癌的早期階段，血液樣本中的腫瘤細胞， 可以準確的預測出這名患者生存的機率。

這項發現可以協助提早確認， 患者可能從化學治療等其他附帶治療中獲得益處。

 

Circulating tumour cells in non-metastatic breast cancer: a prospective study

The Lancet Oncology, Early Online Publication, 6 June 2012

Prof Anthony Lucci MD a , Carolyn S Hall PhD a, Ashutosh K Lodhi MD a, Anirban Bhattacharyya MD a, Amber E Anderson BS a,Lianchun Xiao MS c, Isabelle Bedrosian MD a, Prof Henry M Kuerer MD a, Prof Savitri Krishnamurthy MD b

Summary

Background

The identification of circulating tumour cells correlate with poor prognosis in metastatic breast cancer, but there are few data describing the importance of circulating tumour cells in patients with non-metastatic disease. Our aim was to establish if circulating tumour cells predicted worse outcome in patients with non-metastatic breast cancer.

Methods

We prospectively collected data on circulating tumour cells at the time of definitive surgery from chemonaive patients with stage 1—3 breast cancer from February, 2005, to December, 2010. We deemed eligible all patients with operable breast cancer presenting at The University of Texas MD Anderson Cancer Center (Houston, TX, USA). Patients were ineligible if they had bilateral breast cancer or any other malignancy within 5 years of the diagnosis of the present cancer. We measured circulating tumour cells with the CellSearch System (Veridex, Raritan, NJ). We correlated findings of circulating tumour cells with standard tumour characteristics, including tumour size and grade; oestrogen and progesterone receptor and human epidural growth factor receptor 2 (HER2) status; and axillary lymph node status with χ2 or Fisher exact tests. We assessed outcomes at a median follow-up of 35 months. Log-rank test and Cox regression analysis was applied to establish the association of circulating tumour cells with progression-free and overall survival.

Findings

No patients reported adverse events or complications from blood collections. We identified one or more circulating tumour cells in 73 (24%) of 302 patients. Detection of one or more circulating tumour cells predicted both decreased progression-free survival (log-rank p=0·005; hazard ratio [HR] 4·62, 95% CI 1·79—11·9) and overall survival (log-rank p=0·01; HR 4·04, 1·28—12·8).

Interpretation

The presence of one or more circulating tumour cells predicted early recurrence and decreased overall survival in chemonaive patients with non-metastatic breast cancer. These results suggest that assessment of circulating tumour cells might provide important prognostic information in these patients.

Funding

Society of Surgical Oncology, Morgan Welch Inflammatory Breast Cancer Program, The University of Texas MD Anderson Cancer Center, and the State of Texas Rare and Aggressive Breast Cancer Research Program.