title: Full-length cytokeratin-19 is released by human tumor cells: a potential role in metastatic progression of breast cancer.
abstract: BACKGROUND
  We evaluated whether CK19, one of the main cytoskeleton proteins of epithelial cells, is released as full-length protein from viable tumor cells and whether this property is relevant for metastatic progression in breast cancer patients.
  
  
  METHODS
  EPISPOT (EPithelial ImmunoSPOT) assays were performed to analyze the release of full-length CK19 by carcinoma cells of various origins, and the sequence of CK19 was analyzed with mass spectrometry. Additional functional experiments with cycloheximide, Brefeldin A, or vincristine were done to analyze the biology of the CK19-release. CK19-EPISPOT was used to detect disseminated tumor cells in bone marrow (BM) of 45 breast cancer patients who were then followed up over a median of 6 years.
  
  
  RESULTS
  CK19 was expressed and released by colorectal (HT-29, HCT116, Caco-2) and breast (MCF-7, SKBR3, and MDA-MB-231) cancer cell lines. The CK19-EPISPOT was more sensitive than the CK19-ELISA. Dual fluorescent EPISPOT with antibodies against different CK19 epitopes showed the release of the full-length CK19, which was confirmed by mass spectrometry. Functional experiments indicated that CK19 release was an active process and not simply the consequence of cell death. CK19-releasing cells (RCs) were detectable in BM of 44% to 70% of breast cancer patients. This incidence and the number of CK19-RCs were correlated to the presence of overt metastases, and patients with CK19-RCs had a reduced survival as compared with patients without these cells (P = 0.025, log-rank test; P = 0.0019, hazard ratio, 4.7; multivariate analysis).
  
  
  CONCLUSIONS
  Full-length CK19 is released by viable epithelial tumor cells, and CK19-RCs might constitute a biologically active subset of breast cancer cells with high metastatic properties.
authors: Department of Virology, Lapeyronie Hospital, University Medical Center of Montpellier, Montpellier Cedex 5, France. panabieres@yahoo.fr
authors: Catherine
authors: C
authors: Alix-Panabières
authors: Jean-Pierre
authors: JP
authors: Vendrell
authors: Monique
authors: M
authors: Slijper
authors: Olivier
authors: O
authors: Pellé
authors: Eric
authors: E
authors: Barbotte
authors: Grégoire
authors: G
authors: Mercier
authors: William
authors: W
authors: Jacot
authors: Michel
authors: M
authors: Fabbro
authors: Klaus
authors: K
authors: Pantel
mesh_terms: D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism*; D045744:Cell Line, Tumor; D018450:Disease Progression; D004847:Epithelial Cells / Q000378:metabolism; D000939:Epitopes; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053539:Keratin-19 / Q000096:biosynthesis*; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis
chemical_list: D000939:Epitopes; D053539:Keratin-19