Detection o f I solated T umor C ells i n B one M arrow I s a n Independent P rognostic F actor i n B reast C ancer

摘要: Purpose: This study was performed to disclose the clinical impact of isolated tumor cell (ITC) detection in bone marrow (BM) breast cancer. Patients and Methods: BM aspirates were collected from 817 patients at primary surgery. Tumor cells detected by immunocytochemistry using anticytokeratin antibodies (AE1/AE3). Analyses included histologic grading, vascular invasion, immunohistochemical c-erbB-2, cathepsin D, p53, estrogen receptor (ER)/progesterone (PgR) expression. These analyses compared with outcome. The median follow-up 49 months. Results: ITC 13.2% patients. rate rose increasing size (P .011) lymph node involvement < .001). Systemic relapse death cancer occurred 31.7% 26.9% BM-positive versus 13.7% 10.9% BMnegative patients, respectively Analyzing nodepositive node-negative separately, positivity associated poor prognosis node-positive group not receiving adjuvant therapy (T1N0). In multivariate analysis, an independent prognostic factor together node, tumor, ER/PgR status, grade, invasion. separate analysis T1N0 grade independently both distant diseasefree survival (DDFS) cancer–specific (BCSS), BCSS, invasion DDFS. Conclusion: is predictor DDFS BCSS. An unfavorable observed for systemic therapy. A combination several factors can classify subgroups into excellent high-risk groups. J Clin Oncol 21:3469-3478. © 2003 American Society Clinical Oncology. LARGE proportion experience relapse, approximately 25% 30% nodenegative 60% 1,2 At present, metastasis (TNM) classification, histopathologic hormone age are used prognostication treatment decisions. However, these sufficient accurate selection low-risk groups, no need therapy, groups relapse. Extensive work has been develop methods assessment risk. presence time operation shown be a early studies. 3-8 reported results have contradictory. 4,5,8-10 Most studies immunocytochemical (ICC) techniques ITC. Methodologic differences between exist 9,11 that may cause sensitivity specificity. Therefore, guidelines evaluation ICC BM, proposed European Working Group Standardization Cell Detection, this study. 12 aim examine early-stage clarify their value, analyze relate candidate tumors outcome unselected PATIENTS AND METHODS