DIE KLINISCHE BEDEUTUNG DERBESTIMMUNG VON DEN ZIERKULIERENDENTUMORZELLEN BEI DEN PATIENTEN MIT DEMDISSEMINIERTEN MAMMAKARZINOM
At least one per million circulating tumor cells (CTC) are found in 41.3% of patients with advanced breast cancer. The CTC level is not related to site or number of metasta tic tumors, nor to receptor status of the primary breast cancer. The CTC are found more frequently in menopausal than in premenopausal women (47.8% vs 26.7%, p=0.044). Patients with infiltrative lobular disease present with CTC significantly more frequently than those with infiltrative ductal breast cancer (69.2% vs 31%, p=0.02). Bone marrow involvement has no influence on CTC detection frequency. The CTC are detected at similar frequency before and after treatment (41.3% vs 45.5%). CTCposi tivity has no effect on overall or diseasefree survival of patients with advanced breast cancer. Analysis of CTC levels before and after systemic cancer chemo or hor monotherapy demonstrated that patients with diminution of CTC number after treat ment had significantly longer time to disease progression than those with increased CTC levels after treatment (14 vs 8 months, p=0.0127). Changes in CTC levels after specific anticancer treatment may be a new useful, objective measure of response and an informative prognostic factor in patients with advanced breast cancer. CTC from breast cancer patients demonstrated different expression of major histocompatibility complex (HLADR) class II molecules and CD95 receptor. Breast cancer patients pre sented with an almost twofold decreased proportions of HLADR and CD95positive CTC in peripheral blood after treatment.