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首页> 外文期刊>Pathobiology: journal of immunopathology, molecular and cellular biology >Disseminated tumor cells in bone marrow and circulating tumor cells in blood of breast cancer patients: current state of detection and characterization.
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Disseminated tumor cells in bone marrow and circulating tumor cells in blood of breast cancer patients: current state of detection and characterization.

机译：乳腺癌患者骨髓中已扩散的肿瘤细胞和血液中循环中的肿瘤细胞：检测和表征的当前状态。

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Despite the progress resulting from early detection and improved adjuvant therapy, the prognosis of breast cancer patients is still limited by the occurrence of distant metastases largely due to clinically occult micrometastases that remain undetected at primary diagnosis even by high-resolution imaging approaches. Recent research efforts have concentrated on the identification of additional parameters allowing individual risk assessment and stratification of patients for targeted therapies, since traditional prognostic factors are not sufficient to predict metastatic relapse and treatment decisions are still mainly based on statistical risk parameters. Highly sensitive and specific immunocytochemical and molecular assays now enable the detection and characterization of disseminated and circulating tumor cells (DTCs and CTCs, respectively) at the single cell level in bone marrow (BM) and peripheral blood, providing insights into the first crucial steps of the metastatic cascade. However, because of thestill high variability of results in DTC/CTC detection, the necessity of standardized approaches will be discussed. A large number of studies showed that the presence of DTCs in BM has prognostic impact for primary breast cancer patients. DTCs are likely to escape from chemotherapy by maintaining a dormant nonproliferating state. There is also evidence for a stem cell-like phenotype of DTCs, probably contributing to the opportunity to escape from dormancy control and to start expansion to manifest metastases. Blood would also be an ideal source for the detection and monitoring of CTCs because of an easy noninvasive sampling procedure enabling repeated analyses. While prognostic significance of CTCs could be reliably demonstrated for metastatic breast cancer, studies to analyze the impact of CTCs in primary breast cancer patients and the potential to replace or supplement BM analysis are still ongoing. Furthermore, molecular characterization of CTCs might contribute to improving targeted and more individualized cancer therapies.
机译：尽管早期检测和辅助治疗的改善取得了进展，但乳腺癌患者的预后仍然受到远处转移的限制，这主要是由于临床隐匿性微转移，即使在高分辨率影像学方法的诊断下仍未发现。由于传统的预后因素不足以预测转移性复发，而且治疗决策仍主要基于统计学风险参数，因此最近的研究工作集中于确定其他参数，从而可以进行个体风险评估和对患者进行针对性治疗的分层。现在，高度灵敏，特异性强的免疫细胞化学和分子分析能够在骨髓和外周血的单个细胞水平上检测和鉴定已扩散和正在循环的肿瘤细胞（分别为DTC和CTC），从而提供了对转移级联。但是，由于在DTC / CTC检测中结果仍然存在较高的可变性，因此将讨论标准化方法的必要性。大量研究表明，BM中DTC的存在对原发性乳腺癌患者有预后影响。 DTC可能会通过保持休眠的不增殖状态而逃避化疗。也有证据表明DTC具有干细胞样表型，可能有助于摆脱休眠控制并开始扩展以显示转移灶。血液也将是检测和监测CTC的理想来源，因为简单的无创采样程序能够进行重复分析。虽然可以可靠地证明CTC对转移性乳腺癌的预后意义，但仍在进行分析CTC对原发性乳腺癌患者的影响以及替代或补充BM分析的潜力的研究。此外，CTC的分子表征可能有助于改善靶向性和更个性化的癌症治疗方法。

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