Detection of circulating epithelial cells after surgery for benign breast disease.
BACKGROUND
Cytokeratins are predominantly expressed in epithelial cells and their malignant counterparts. Ultrasensitive methods for cytokeratin messenger RNAs (mRNAs) can detect rare circulating tumor cells consistent with hematogenous dissemination in epithelial-derived malignancies, including breast carcinomas. Intraoperative tumor-cell shedding may contribute to this process; this hypothesis is based on the assumption that only tumor cells can be mobilized during surgical manipulation.


RESULTS
The present study addresses this issue by using cytokeratin 19 mRNA detection by reverse transcription-polymerase chain reaction (RT-PCR) in preoperative and postoperative blood samples from 54 patients undergoing excisional biopsy for benign breast disease; 22 healthy volunteers represented the control group. No cytokeratin RT-PCR positivity was found in the control or preoperative samples. Cytokeratin RT-PCR positivity was found in 21 postoperative samples (39%).


CONCLUSIONS
This finding shows that benign epithelial cells can be mobilized during breast surgery; this effect of surgical manipulation warrants caution in the interpretation of RT-PCR positivity for cytokeratin mRNA in the peripheral blood of patients undergoing surgery for breast cancer.
Crisan
D
D
Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI 48073-6769, USA. dcrisan@beaumont.edu
Ruark
D S
DS
Decker
D A
DA
Drevon
A M
AM
Dicarlo
R G
RG
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001941:Breast Diseases / Q000097:blood* / Q000601:surgery; D002469:Cell Separation / Q000379:methods; D004847:Epithelial Cells / Q000378:metabolism; D005260:Female; D006801:Humans; D007633:Keratins / Q000097:blood*; D008875:Middle Aged; D012333:RNA, Messenger / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction
D015415:Biomarkers; D012333:RNA, Messenger; D007633:Keratins