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Detection and Isolation of Circulating Tumor Cells in Urologic Cancers: A Review

Loberg, Robert D.; Fridman, Yaron; Pienta, Brian A.; Keller, Evan T.; McCauley, Laurie K.; Taichman, Russell S.; Pienta, Kenneth J.
Fonte: Neoplasia Press Inc. Publicador: Neoplasia Press Inc.
Tipo: Artigo de Revista Científica
Publicado em /07/2004 EN
Relevância na Pesquisa
66.03%
The American Cancer Society has estimated that in 2003, there will be approximately 239,600 new cases of urologic cancer diagnosed and 54,600 urologic cancer-related deaths in the United States. To date, the majority of research and therapy design have focused on the microenvironment of the primary tumor site, as well as the microenvironment of the metastatic or secondary (target) tumor site. Little attention has been placed on the interactions of the circulating tumor cells and the microenvironment of the circulation (i.e., the third microenvironment). The purpose of this review is to present the methods for the detection and isolation of circulating tumor cells and to discuss the importance of circulating tumor cells in the biology and treatment of urologic cancers.

Recent translational research: circulating tumor cells in breast cancer patients

Müller, Volkmar; Hayes, Daniel F; Pantel, Klaus
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.08%
In breast cancer patients, hematogenous tumor cell dissemination can be detected, even at the single cell level, by applying immunocytochemical and molecular assays. Various methods for the detection of circulating tumor cells in the peripheral blood have been described. Results from recently reported studies suggest that circulating tumor cell levels may serve as a prognostic marker and for the early assessment of therapeutic response in patients with metastatic breast cancer. However, in early-stage breast cancer, the impact of circulating tumor cells is less well established than the presence of disseminated tumor cells in bone marrow; several clinical studies have demonstrated that cells of the latter type are an independent prognostic factor at primary diagnosis. In this article we briefly summarize recent studies examining the presence of circulating tumor cells in the blood and discuss further clinical applications.

Detection of circulating tumor cells in colorectal cancer by immunobead-PCR is a sensitive prognostic marker for relapse of disease.

Hardingham, J. E.; Kotasek, D.; Sage, R. E.; Eaton, M. C.; Pascoe, V. H.; Dobrovic, A.
Fonte: The Feinstein Institute for Medical Research Publicador: The Feinstein Institute for Medical Research
Tipo: Artigo de Revista Científica
Publicado em /11/1995 EN
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66.03%
BACKGROUND: Recurrent and metastatic carcinoma of the colorectum remains a major problem, with survival at 5 years post curative resection still only about 50%. Moreover, up to 30% of patients who present with early stage disease also relapse and die within 5 years, suggesting the presence of micrometastatic disease at diagnosis. One route of metastatic spread is via the blood stream, hence the detection of tumor cells in blood is likely to provide an important predictive tool with respect to relapse of disease. We have developed a sensitive molecular technique to identify tumor cells in blood using mutations in codon 12 of the K-ras gene as a marker. MATERIALS AND METHODS: Twenty-seven patients whose tumor carried a mutation in codon 12 of K-ras were studied for the presence of tumor cells in perioperative peripheral blood samples. Immunomagnetic beads, labeled with an epithelial-specific antibody, were used to harvest epithelial cells from blood. K-ras mutations were identified in this selected population using a polymerase chain reaction (PCR)-based analysis (immunobead-PCR). RESULTS: Circulating K-ras mutant cells were detected in 9 or 27 patients; seven of these nine patients have since died due to recurrent or metastatic disease. Mutant cells were not detected in 18 patients...

Circulating tumor cells in melanoma: a review of the literature and description of a novel technique

Steen, Shawn; Nemunaitis, John; Fisher, Tammy; Kuhn, Joseph
Fonte: Baylor Health Care System Publicador: Baylor Health Care System
Tipo: Artigo de Revista Científica
Publicado em /04/2008 EN
Relevância na Pesquisa
66.09%
Melanoma is a prevalent and deadly disease with limited therapeutic options. Current prognostic factors are unable to adequately guide treatment. Circulating tumor cells are a disease-specific factor that can be used as a prognostic variable to guide therapy. Most research to date has focused on identification of circulating tumor cells using various methods, including polymerase chain reaction. These techniques, however, have poor sensitivity and variable specificity and predictive significance. A recently developed technology to identify circulating tumor cells is the CellSearch system. This system uses immunomagnetic cell labeling and digital microscopy. This technology may provide an alternative method to identify circulating tumor cells in patients with advanced-stage melanoma and function as a prognostic factor. We review the literature on circulating tumor cells in melanoma and present data collected at our institution using the CellSearch system in nine patients with stage III or IV melanoma.

Nanowire Substrate-based Laser Scanning Cytometry for Quantitation of Circulating Tumor Cells

Lee, Sang-Kwon; Kim, Gil-Sung; Wu, Yu; Kim, Dong-Joo; Lu, Yao; Kwak, Minsuk; Han, Lin; Hyung, Jung-Hwan; Seol, Jin-Kyeong; Sander, Chantal; Gonzalez, Anjelica; Li, Jie; Fan, Rong
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.08%
We report on the development of a nanowire substrate-enabled laser scanning imaging cytometry for rare cell analysis in order to achieve quantitative, automated, and functional evaluation of circulating tumor cells. Immuno-functionalized nanowire arrays have been demonstrated as a superior material to capture rare cells from heterogeneous cell populations. The laser scanning cytometry method enables large-area, automated quantitation of captured cells and rapid evaluation of functional cellular parameters (e.g. size, shape and signaling protein) at the single-cell level. This integrated platform was first tested for capture and quantitation of human lung carcinoma cells from a mixture of tumor cells and leukocytes. We further applied it to the analysis of rare tumor cells spiked in fresh human whole blood (several cells per mL) that emulate metastatic cancer patient blood and demonstrated the potential of this technology for analyzing circulating tumor cells in the clinical settings. Using a high-content image analysis algorithm, cellular morphometric parameters and fluorescence intensities can be rapidly quantitated in an automated, unbiased, and standardized manner. Together, this approach enables informative characterization of captured cells in situ and potentially allows for sub-classification of circulating tumor cells...

Circulating tumor cells in non-small cell lung carcinoma

Boshuizen, Rogier; Kuhn, Peter; van den Heuvel, Michel
Fonte: Pioneer Bioscience Publishing Company Publicador: Pioneer Bioscience Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2012 EN
Relevância na Pesquisa
96.02%
Circulating tumor cells (CTCs) are associated with survival of cancer patients. Several methods have been developed to detect circulating tumor cells. The number of CTCs in NSCLC is lower than in other solid tumors. To date, trials are ongoing for a better understanding of CTCs. Besides association with prognosis, CTCs can be used to assess the efficacy of treatment and they are important substrates for molecular profiling of the tumor..

Antibody-independent isolation of circulating tumor cells by continuous-flow dielectrophoresis

Shim, Sangjo; Stemke-Hale, Katherine; Tsimberidou, Apostolia M.; Noshari, Jamileh; Anderson, Thomas E.; Gascoyne, Peter R. C.
Fonte: American Institute of Physics Publicador: American Institute of Physics
Tipo: Artigo de Revista Científica
Publicado em 16/01/2013 EN
Relevância na Pesquisa
66.03%
Circulating tumor cells (CTCs) are prognostic markers for the recurrence of cancer and may carry molecular information relevant to cancer diagnosis. Dielectrophoresis (DEP) has been proposed as a molecular marker-independent approach for isolating CTCs from blood and has been shown to be broadly applicable to different types of cancers. However, existing batch-mode microfluidic DEP methods have been unable to process 10 ml clinical blood specimens rapidly enough. To achieve the required processing rates of 106 nucleated cells/min, we describe a continuous flow microfluidic processing chamber into which the peripheral blood mononuclear cell fraction of a clinical specimen is slowly injected, deionized by diffusion, and then subjected to a balance of DEP, sedimentation and hydrodynamic lift forces. These forces cause tumor cells to be transported close to the floor of the chamber, while blood cells are carried about three cell diameters above them. The tumor cells are isolated by skimming them from the bottom of the chamber while the blood cells flow to waste. The principles, design, and modeling of the continuous-flow system are presented. To illustrate operation of the technology, we demonstrate the isolation of circulating colon tumor cells from clinical specimens and verify the tumor origin of these cells by molecular analysis.

Anti-mitotic chemotherapeutics promote adhesive responses in detached and circulating tumor cells

Balzer, Eric M.; Whipple, Rebecca A.; Cho, Edward H.; Matrone, Michael A.; Martin, Stuart S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.03%
In the clinical treatment of breast cancer, anti-mitotic cytotoxic agents are one of the most commonly employed chemotherapies, owing largely to their antiproliferative effects on the growth and survival of adherent cells in studies that model primary tumor growth. Importantly, the manner in which these chemotherapeutics impact the metastatic process remains unclear. Furthermore, since dissemination of tumor cells through the systemic circulation and lymphatics necessitates periods of detached survival, it is equally important to consider how circulating tumor cells respond to such compounds. To address this question, we exposed both nontumorigenic and tumor-derived epithelial cell lines to two anti-tumor compounds, jasplakinolide and paclitaxel (Taxol), in a series of attached and detached states. We report here that jasplakinolide promoted the extension of microtubule-based projections and microtentacle protrusions in adherent and suspended cells, respectively. These protrusions were specifically enriched by upregulation of a stable post-translationally modified form of α-tubulin, and this occurred prior to, and independently of any reductions in cellular viability. Microtubule-stabilization with Taxol significantly enhanced these effects. Additionally...

Nanotheranostics of Circulating Tumor Cells, Infections and Other Pathological Features In Vivo

Kim, Jin-Woo; Galanzha, Ekaterina I.; Zaharoff, David A.; Griffin, Robert J.; Zharov, Vladimir P.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
66.08%
Many life-threatening diseases are disseminated through biological fluids, such as blood, lymph and cerebrospinal fluid. The migration of tumor cells through the vascular circulation is a mandatory step in metastasis, which is responsible for ∼90% of cancer-associated mortality. Circulating pathogenic bacteria, viruses, or blood clots lead to other serious conditions including bacteremia, sepsis, viremia and infarction. Therefore, technologies capable of detecting circulating tumor cells (CTCs), circulating bacterial cells (CBCs), circulating endothelial cells (CECs), cancer biomarkers such as microparticles and exosomes, which contain important microRNA signatures, and other abnormal features in biological fluids may facilitate early diagnosis and treatment of metastatic cancers, infections and adverse cardiovascular events. Unfortunately, even in a disease setting, circulating abnormal cells are rare events that are easily obscured by the overwhelming background material in whole blood. Existing detection methods mostly rely on ex vivo analyses of limited volumes (a few mL) of whole blood. These small volumes limit the probability of detecting CTCs, CECs, CBCs and other rare phenomena. In vivo detection platforms capable of continuously monitoring the entire circulation may substantially increase the probability of detecting circulating abnormal cells and...

Circulating Tumor Cells: Who is the Killer?

Paterlini-Bréchot, Patrizia
Fonte: Springer Netherlands Publicador: Springer Netherlands
Tipo: Artigo de Revista Científica
Publicado em 20/12/2014 EN
Relevância na Pesquisa
66.05%
This article is a critical note on the subject of Circulating Tumor Cells (CTC). It takes into account the tumor identity of Circulating Tumor Cells as cancer seeds in transit from primary to secondary soils, rather than as a “biomarker”, and considers the help this field could bring to cancer patients. It is not meant to duplicate information already available in a large number of reviews, but to stimulate considerations, further studies and development helping the clinical use of tumor cells isolated from blood as a modern personalized, non-invasive, predictive test to improve cancer patients’ life. The analysis of CTC challenges, methodological bias and critical issues points out to the need of referring to tumor cells extracted from blood without any bias and identified by cytopathological diagnosis as Circulating Cancer Cells (CCC). Finally, this article highlights recent developments and identifies burning questions which should be addressed to improve our understanding of the domain of CCC and their potential to change the clinical practice.

Reproducible copy number variation patterns among single circulating tumor cells of lung cancer patients

Ni, Xiaohui; Zhuo, Minglei; Su, Zhe; Duan, J.; Gao, Yan; Wang, Z.; Zong, Chenghang; Bai, H.; Chapman, Alec Randolph; Zhao, J.; Xu, L.; An, T.; Ma, Q.; Wang, Y.; Wu, M.; Sun, Y.; Wang, S.; Li, Z.; Yang, X.; Yong, Jun; Su, X.-D.; Lu, Y.; Bai, F.; Xie, Xiaol
Fonte: Proceedings of the National Academy of Sciences Publicador: Proceedings of the National Academy of Sciences
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
95.96%
Circulating tumor cells (CTCs) enter peripheral blood from primary tumors and seed metastases. The genome sequencing of CTCs could offer noninvasive prognosis or even diagnosis, but has been hampered by low single-cell genome coverage of scarce CTCs. Here, we report the use of the recently developed multiple annealing and looping-based amplification cycles for whole-genome amplification of single CTCs from lung cancer patients. We observed characteristic cancer-associated single-nucleotide variations and insertions/deletions in exomes of CTCs. These mutations provided information needed for individualized therapy, such as drug resistance and phenotypic transition, but were heterogeneous from cell to cell. In contrast, every CTC from an individual patient, regardless of the cancer subtypes, exhibited reproducible copy number variation (CNV) patterns, similar to those of the metastatic tumor of the same patient. Interestingly, different patients with the same lung cancer adenocarcinoma (ADC) shared similar CNV patterns in their CTCs. Even more interestingly, patients of small-cell lung cancer have CNV patterns distinctly different from those of ADC patients. Our finding suggests that CNVs at certain genomic loci are selected for the metastasis of cancer. The reproducibility of cancer-specific CNVs offers potential for CTC-based cancer diagnostics.; Chemistry and Chemical Biology

Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma

Winter, S.; Stephenson, S.; Subramaniam, S.; Paleri, V.; Ha, K.; Marnane, C.; Krishnan, S.; Rees, G.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
66.09%
Background: Techniques for detecting circulating tumor cells in the peripheral blood of patients with head and neck cancers may identify individuals likely to benefit from early systemic treatment. Methods: Reconstruction experiments were used to optimise immunomagnetic enrichment and RT-PCR detection of circulating tumor cells using four markers (ELF3, CK19, EGFR and EphB4). This method was then tested in a pilot study using samples from 16 patients with advanced head and neck carcinomas. Results: Seven patients were positive for circulating tumour cells both prior to and after surgery, 4 patients were positive prior to but not after surgery, 3 patients were positive after but not prior to surgery and 2 patients were negative. Two patients tested positive for circulating cells but there was no other evidence of tumor spread. Given this patient cohort had mostly advanced disease, as expected the detection of circulating tumour cells was not associated with significant differences in overall or disease free survival. Conclusion: For the first time, we show that almost all patients with advanced head and neck cancers have circulating cells at the time of surgery. The clinical application of techniques for detection of spreading disease...

Detecting uterine cervical cancer cells using molecular biomarkers

Mousa, Ahmed
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
EN
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76.05%
Arrière-plan: les cellules tumorales circulantes (CTC) sont détectables dans de nombreux cancers et peuvent être utiles cliniquement pour le pronostic de la maladie, pour mesurer la récidive et pour prédire la sensibilité aux medicaments chimiothérapeutiques. Au cours des dernières années, l’études des CTC dans de nombreux cancers tels que le cancer du sein, du poumon, du côlon et de la prostate a grandement évolué. Alternativement, il y peu d'études à ce sujet concernant le cancer du col de l’utérus (CCU). Objectifs: Notre objectif est d’optimiser le processus d'enrichissement des CTC dans le CCU et la détection moléculaire des biomarqueurs E6 et E7. Matériel et Méthodes: Dans l’optique de mimer la présence de CTC dans le sang, nous avons dilué des cellules cancéreuses CaSki VPH16-positif provenant d’un CCU dans du sang humain prélevé sur des volontaires sains. Les CaSki ont été collectées suite à une centrifugation par densité avec le Ficoll, la lyse des globules rouges (RBC) et la lyse des RBC combinée avec un enrichissement positif et négatif à l’aide de marqueurs de surface cellulaire. Les CTC ont été détectées par la mesure d’expression des oncogènes E6 et E7 du virus du papillome humain (VPH)...

Interaction between circulating cancer cells and platelets: clinical implication

Lou, Xiao-Liang; Sun, Jian; Gong, Shu-Qi; Yu, Xue-Feng; Gong, Rui; Deng, Huan
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2015 EN
Relevância na Pesquisa
85.91%
Metastasis is the main cause of cancer-associated mortality. During this complicated process, some cancer cells, also called circulating tumor cells (CTCs), detach from primary sites, enter bloodstream and extravasate at metastatic site. Thrombocytosis is frequently observed in patients with metastatic cancers suggesting the important role of platelets in metastasis. Therefore this review focuses on how platelets facilitate the generation of CTCs, protect them from various host attacks, such as immune assaults, apoptosis and shear stress, and regulate CTCs intravasation/extravasation. Platelet-derived cytokines and receptors are involved in this cascade. Identification the mechanisms underlie platelet-CTCs interactions could lead to the development of new platelet-targeted therapeutic strategy to reduce metastasis.

Notes for developing a molecular test for the full characterization of circulating tumor cells

Rossi, Elisabetta; Facchinetti, Antonella; Zamarchi, Rita
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2015 EN
Relevância na Pesquisa
85.99%
The proved association between the circulating tumor cell (CTC) levels and the patients’ survival parameters has been growing interest to investigate the molecular profile of these neoplastic cells among which hide out precursors capable of initiating a new distant metastatic lesion. The full characterization of the tumor cells in peripheral blood of cancer patients is expected to be of help for understanding and (prospectively) for counteracting the metastatic process. The major hitch that is hampering the successful gaining of this result is the lack of a consensus onto standard operating procedures (SOPs) for performing what we generally define as the “liquid biopsy”. Here we review the more recent acquisitions in the analysis of CTCs and tumor related nucleic acids, looking to the main open questions that are hampering their definitive employ in the routine clinical practice.

Circulating tumor cells isolation: the “post-EpCAM era”

Raimondi, Cristina; Nicolazzo, Chiara; Gradilone, Angela
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2015 EN
Relevância na Pesquisa
95.96%
Circulating tumor cells (CTCs) represent a submicroscopic fraction detached from a primary tumor and in transit to a secondary site. The prognostic significance of CTCs in metastatic cancer patients was demonstrated for the first time more than ten years ago. To date, it seems clear enough that CTCs are highly heterogeneous and dynamically change their shape. Thus, the inadequacy of epithelial cell adhesion molecule (EpCAM) as universal marker for CTCs detection seems unquestionable and alternative methods able to recognize a broader spectrum of phenotypes are definitely needed. In this review the pleiotropic functions of EpCAM are discussed in detail and the role of the molecule in the biology of CTCs is critically dissected.

Circulating tumor cell isolation: the assets of filtration methods with polycarbonate track-etched filters

Dolfus, Claire; Piton, Nicolas; Toure, Emmanuel; Sabourin, Jean-Christophe
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2015 EN
Relevância na Pesquisa
85.91%
Circulating tumor cells (CTCs) arise from primary or secondary tumors and enter the bloodstream by active or passive intravasation. Given the low number of CTCs, enrichment is necessary for detection. Filtration methods are based on selection of CTCs by size using a filter with 6.5 to 8 µm pores. After coloration, collected CTCs are evaluated according to morphological criteria. Immunophenotyping and fluorescence in situ hybridization techniques may be used. Selected CTCs can also be cultivated in vitro to provide more material. Analysis of genomic mutations is difficult because it requires adapted techniques due to limited DNA materials. Filtration-selected CTCs have shown prognostic value in many studies but multicentric validating trials are mandatory to strengthen this assessment. Other clinical applications are promising such as follow-up, therapy response prediction and diagnosis. Microfluidic emerging systems could optimize filtration-selected CTCs by increasing selection accuracy.

Circulating cancer stem cells: the importance to select

Yang, Ming-Hsin; Imrali, Ahmet; Heeschen, Christopher
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /10/2015 EN
Relevância na Pesquisa
76.12%
It has been demonstrated that even localized tumors without clinically apparent metastasis give rise to circulating tumor cells (CTCs). A growing number of technically diverse platforms are being developed for detecting/isolating CTCs in the circulating blood. Despite the technical challenges of isolating rare CTCs from blood, recent studies have already shown the predictive value of CTCs enumeration. Thus, it is becoming increasingly accepted that CTC numbers are linked to patients’ outcome and may also be used to monitor treatment response and disease relapse, respectively. Further CTCs provide a non-invasive source for tumor material, ‘liquid biopsy’, which is particularly important for patients, where no biopsy material can be obtained or where serial biopsies of the tumor, e.g., following treatment, are practically impossible. On the other hand the molecular and biological characterization of CTCs has still remained at a rather experimental stage. Future studies are necessary to define CTC heterogeneity to establish the crucial role of circulating cancer stem cells for driving metastasis, which represent a distinct subpopulation of CTCs that bear metastasis-initiating capabilities based on their stemness properties and invasiveness and thus are critical for the patients’ clinical outcome. As compared to non-tumorigenic/metastatic bulk CTCs...

Feasibility of capturing circulating tumor cells with a magnetized device

Wheaton, Jay
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
75.88%
A standard inferior vena cava (IVC) filter is plated with Nickel in order to be rendered magnetizable. In the presence of an applied magnetic field, the IVC filter has a strong magnetic gradient near the surface that captures circulating tumor cells (CTCs) tagged with paramagnetic nanoparticles. Particle motion and capture includes a balance of the magnetization force and hydrodynamic drag force. ANSYS Fluent CFD software and ANSYS Workbench Magnetostatics were used independently to obtain fluid velocity and magnetic field intensity solutions. The separate solutions were combined in Matlab for numerical particle tracking. Empirical capture efficiency was determined using in-flow spectrometer absorbance measurements as well as measuring image intensity from time-lapse fluorescent images. Three control experiments were used to ensure particles caught in the continuous flow loop are not falsely attributed to the magnetizable IVC filter. Fluorescent magnetite coated spheres, 8.34 micron in diameter, were used for developing methods while magnetically tagged cancer cells were used to determine practical feasibility. Results from the numerical model predict eight percent capture efficiency for a single pass through the IVC filter. Experimental results showed capture efficiency of paramagnetic particles in a continuous loop at 0.3 L/min was ninety-five percent after six hours. For the same experiment...

Detection and characteristics of primary circulating prostate cells

Murray,Nigel P.; Reyes,Eduardo; Badínez,Leonardo; Orellana,Nelson; Dueñas,Ricardo; Fuentealba,Cinthia
Fonte: Archivos Españoles de Urología (Ed. impresa) Publicador: Archivos Españoles de Urología (Ed. impresa)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2010 ENG
Relevância na Pesquisa
75.84%
Objectives: To determine the frequency of primary circulating prostate cells in men with prostate cancer at the time of diagnosis, the association with micrometastasis, sub-classification for CD82 and the relation with pathological stage. To determine their clinical usefulness to identify patients in whom radical prostatectomy would be first choice therapy. Methods: Men with the diagnosis of prostate cancer before definitive therapy. Blood and bone marrow samples were taken, mononuclear cells separated by differential centrifugation and prostate cells identified with immunocytochemistry using anti-PSA. Positive samples were sub-classified with anti-CD82. Details of serum PSA, Gleason score and pathological stage were registered. Results: Of 77 men 58 (75.3%) had primary CPCs detected, there was an association with stage but not Gleason. 31 (40.3%) had micrometastasis with an association with stage and Gleason score. CPC-negative patients had fewer micrometastasis detected, 1/19 versus 30/58 (p<0.003). There was an inverse relation between CD82 expression and Gleason score, men with CPCs expressing CD82 had fewer micrometastasis. The combined group of CPC negative and CPC positive CD82 positive men showed a sensitivity of 87% and specificity of 73.9% for the absence of micrometastasis. Conclusions: The detection of CPCs and sub-classification with CD82 could be clinically useful to identify men with a significantly lower risk of micrometastais and as a consequence to identify men in whom radical prostatectomy could be the best initial treatment.