Abstract
Background
In 100 consecutive patients with node-negative breast cancer who underwent curative
surgery, we prospectively tested whether detection of circulating tumor cells in peripheral
blood by means of reverse transcription-polymerase chain reaction for carcinoembryonic
antigen (CEA) messenger RNA (mRNA) could predict patient outcomes.
Methods
We performed reverse transcription-polymerase chain reaction in blood samples taken
before surgery and in repeat samples taken 2 to 3 weeks after surgery. Univariate
and multivariate analyses of relapse-free survival were performed.
Results
Patients with CEA mRNA in preoperative samples had poorer survival rates than those
who had no detectable CEA mRNA. The worst survival rate was seen in those with CEA
mRNA in both pre- and postoperative samples. Stepwise multivariate analysis selected
CEA mRNA expression pattern (P = .001; relative risk = 0.69) and histologic tumor grade (P = .002; relative risk = 1.35) as independent prognostic factors for disease-free survival.
Conclusions
Molecular detection of CEA mRNA in both pre- and postoperative blood samples is an
independent, negative prognostic factor in patients with node-negative breast cancer
undergoing curative surgery.
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References
- National Cancer Institute of Health Consensus Development Panel: National Institute of Health Consensus Development Conference Statement: Adjuvant Therapy for Breast Cancer, November 1–3, 2000.J Natl Cancer Inst. 2001; 93: 979-989
- Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer.J Clin Oncol. 2001; 19: 3817-3827
- The molecular detection of circulating tumour cells.Br J Cancer. 1995; 72: 268-276
- Epithelial membrane antigen and lymphoid cells.Lancet. 1985; 1: 109
- Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction.Lancet. 1991; 338: 1227-1229
- Specific detection of carcinoembryonic antigen-expressing tumor cells in bone marrow aspirates by polymerase chain reaction.J Clin Oncol. 1994; 12: 725-729
- Molecular detection of circulating solid carcinoma cells in the peripheral blood: the concept of early systemic disease.Int J Cancer. 1996; 68: 739-743
- The biology of human cancer metastasis.Acta Oncol. 1991; 30: 669-675
- Histologic typing of breast tumours.in: International histologic classification of tumours, no. 2. World Health Organization, Geneva1981: 35-62
- Histologic classification of breast tumors.in: General rules for clinical and pathological record of mammary cancer. 14th ed. Kanehara, Tokyo2000: 19-56
- Histologic grading and prognosis in breast cancer: a study of 1049 cases of which 359 have been followed for 15 years.Br J Cancer. 1957; 11: 359-377
- The sequence of vessel ligation affects tumor release into the circulation.J Thorac Cardiovasc Surg. 1998; 116: 107-113
- Single-step method of RNA isolation by acid guanidium thiocyanate-phenol-chloroform extraction.Anal Biochem. 1987; 162: 156-159
- Detection of circulating tumor cells by reverse transcriptase-polymerase chain reaction in patients with resectable non-small cell lung cancer.Surgery. 1999; 126: 820-826
- Nonparametric estimation for incomplete observations.J Am Stat Assoc. 1958; 53: 457-481
- Statistical aspects of the analysis of data from retrospective studies of disease.J Natl Cancer Inst. 1959; 22: 719-748
- Regression models and life-tables.J R Stat Soc [B]. 1972; 34: 187-220
- Detection of colorectal cancer cells in peripheral blood by reverse-transcriptase polymerase chain reaction for cytokeratin 20.Int J Cancer. 1998; 79: 288-293
- Comparative analysis of bone marrow and venous blood isolates from gastrointestinal cancer patients for the detection of disseminated tumor cells using reverse transcription PCR.Cancer Res. 1997; 57: 3106-3110
- Preoperative evidence of circulating tumor cells by reverse transcriptase-polymerase chain reaction for CEA mRNA is an independent predictor of survival in non-small cell lung cancer: A prospective study.J Thorac Cardiovasc Surg. 2002; 124: 299-305
- Surgical manipulation of VX2 carcinoma in the rabbit liver evokes enhancement of metastases.J Surg Res. 1990; 49: 92-97
- Detection of circulating tumor cells in patients with non-small cell lung cancer undergoing lobectomy by video-assisted thoracic surgery: a potential hazard for intraoperative hematogenous tumor cell dissemination.J Thorac Cardiovasc Surg. 2000; 119: 899-905
- Haematogenous dissemination of cells from human renal adenocarcinoma.Br J Cancer. 1988; 54: 32-35
- The fate and prognostic value of occult metastatic cells in the bone marrow of patients with breast carcinoma between primary treatment and recurrence.Cancer. 2001; 92: 46-53
Article info
Publication history
Accepted:
August 10,
2003
Nagakute and Kumamoto, JapanFootnotes
☆Supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Education, Science and Culture of Japan to J. Y.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
