Μελέτη των μικρομεταστάσεων σε ασθενείς με πρώιμο καρκίνο του μαστού: η σχέση μεταξύ της χειρουργικής επέμβασης και των κυκλοφορούντων καρκινικών κυττάρων στο αίμα

Abstract

Aims: The aim of this study was to evaluate the effect of surgery on the kinetics of CTCs in breast cancer patients.Methods: The detection of CK-19 mRNA-positive CTCs by real time RT-PCR in the blood was analysed in 104 stage 0-IIIA patients at 4 different time-points: prior to surgery, upon completion, 24 hours after surgery and 15 days after surgery. Furthermore, two late samples were assessed, prior to initiation of adjuvant chemotherapy and at the first follow-up visit after adjuvant chemotherapy, in a subgroup of 53 patients. As negative controls, peripheral blood was obtained from 50 female patients undergoing excision of benign breast lesions and from 11 female patients receiving surgery for early stage colorectal cancer.Results: A significant percentage of breast cancer patients (14.4%) whose blood samples were negative for CK-19 preoperatively, turned transiently positive early postoperatively. However, no significant difference in CK-19 mRNA detection was noted among the first 4 examined time-points. There was no significant correlation between CK-19 mRNA-positive cells and classic prognostic factors. A significant increase in CK-19 mRNA-positivity (32.1%) was observed in a late sample of the subgroup of 53 patients before adjuvant chemotherapy after a median of 54 days, postoperatively.Conclusions: The surgical procedure may result in transient CTCs detection in a small proportion of early breast cancer patients. There is no clear correlation to indicate which patients are expected to have detectable CTCs. Although in the perioperative period CTCs are detected in a small proportion of patients, the detection rate may increase over time and with longer follow-up.