title: Serial quantitative PCR analysis of bone marrow samples from breast cancer patients to monitor systemic micrometastases.
abstract: BACKGROUND
  We have previously developed a quantitative calibrated PCR assay to measure cytokeratin 19 (CK19) expression in haematopoietic tissue in order to detect systemic micrometastases.
  
  
  METHODS
  Serial measurements of CK19 expression in bone marrow of patients with primary breast cancer were performed at operation, at 3 weeks and 6 months postoperatively.
  
  
  RESULTS
  Reference values for CK19 expression were established by analysing bone marrow samples from 48 healthy female volunteers or patients without epithelial cancer. Samples from breast cancer patients with CK19 values above the upper reference limit were considered positive. Bone marrow samples taken at operation were positive in 29 out of 141 patients (20.6%) and remained positive in 12, turned negative in 4 and were unavailable in 13 at 6 months postoperatively.
  
  
  CONCLUSIONS
  Serial measurements increase the reliability of detecting micrometastases perioperatively. Further studies are in progress to evaluate the relationship between elevated CK19 values and clinical outcome.
authors.affiliation: Department of Clinical Chemistry, Rogaland Central Hospital, Stavanger, Norway. shammas@online.no
authors.forename: F V
authors.initials: FV
authors.lastname: Shammas
authors.forename: E
authors.initials: E
authors.lastname: Deak
authors.forename: A
authors.initials: A
authors.lastname: Nysted
authors.forename: J A
authors.initials: JA
authors.lastname: van Eekelen
authors.forename: A
authors.initials: A
authors.lastname: Osland
authors.forename: R
authors.initials: R
authors.lastname: Heikkilä
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001853:Bone Marrow / Q000378:metabolism* / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000378:metabolism / Q000556:secondary*; D001943:Breast Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018076:DNA, Complementary / Q000096:biosynthesis / Q000235:genetics; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007633:Keratins / Q000096:biosynthesis* / Q000097:blood / Q000235:genetics; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D013629:Tamoxifen / Q000008:administration & dosage
chemical_list: D018076:DNA, Complementary; D013629:Tamoxifen; D015251:Epirubicin; D007633:Keratins; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate