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.
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.
Xenidis
Nikos
N
Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece.
Perraki
Maria
M
Kafousi
Maria
M
Apostolaki
Stella
S
Bolonaki
Irene
I
Stathopoulou
Aliki
A
Kalbakis
Kostas
K
Androulakis
Nikos
N
Kouroussis
Charalambos
C
Pallis
Thanos
T
Christophylakis
Charalambos
C
Argyraki
Katerina
K
Lianidou
Evi S
ES
Stathopoulos
Stathis
S
Georgoulias
Vassilis
V
Mavroudis
Dimitris
D
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
D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D007633:Keratins