title: Predictive and prognostic value of peripheral blood cytokeratin-19 mRNA-positive cells detected by real-time polymerase chain reaction in node-negative breast cancer patients.
abstract: OBJECTIVE
  To evaluate the predictive and prognostic value of peripheral blood cytokeratin-19 (CK-19) mRNA-positive cells in axillary lymph node-negative breast cancer patients.
  
  
  METHODS
  Peripheral blood was obtained from 167 node-negative breast cancer patients before the initiation of any systemic adjuvant therapy, and was analyzed for the presence of CK-19 mRNA-positive cells using a real time polymerase chain reaction assay. The association with known prognostic factors and the effect of CK-19 mRNA-positive cells on patients' prognosis was investigated.
  
  
  RESULTS
  CK-19 mRNA-positive cells were detected in the blood of 36 (21.6%) of the 167 patients. There was no correlation between the detection of CK-19 mRNA-positive cells in the peripheral blood and the various known pathologic and clinical prognostic factors; only overexpression of HER2 receptor (score 2+/3+) on the primary tumor was associated with a higher incidence of CK-19 mRNA-positive cell detection (P = .033). Multivariate analysis revealed that detection of peripheral blood CK-19 mRNA-positive cells was associated with early clinical relapse (P < .00001) and disease-related death (P = .008).
  
  
  CONCLUSIONS
  Detection of peripheral-blood CK-19 mRNA-positive cells is an independent predictive and prognostic factor for reduced disease-free interval and overall survival, respectively, in node-negative breast cancer patients.
authors.affiliation: Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Xenidis
authors.forename: Maria
authors.initials: M
authors.lastname: Perraki
authors.forename: Maria
authors.initials: M
authors.lastname: Kafousi
authors.forename: Stella
authors.initials: S
authors.lastname: Apostolaki
authors.forename: Irene
authors.initials: I
authors.lastname: Bolonaki
authors.forename: Aliki
authors.initials: A
authors.lastname: Stathopoulou
authors.forename: Kostas
authors.initials: K
authors.lastname: Kalbakis
authors.forename: Nikos
authors.initials: N
authors.lastname: Androulakis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Kouroussis
authors.forename: Thanos
authors.initials: T
authors.lastname: Pallis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Christophylakis
authors.forename: Katerina
authors.initials: K
authors.lastname: Argyraki
authors.forename: Evi S
authors.initials: ES
authors.lastname: Lianidou
authors.forename: Stathis
authors.initials: S
authors.lastname: Stathopoulos
authors.forename: Vassilis
authors.initials: V
authors.lastname: Georgoulias
authors.forename: Dimitris
authors.initials: D
authors.lastname: Mavroudis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007633:Keratins / Q000097:blood* / Q000235:genetics; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D007633:Keratins