title: Circulating tumour cells lacking cytokeratin in breast cancer: the importance of being mesenchymal.
abstract: Circulating tumour cells (CTCs) are independent predictor of prognosis in metastatic breast cancer. Nevertheless, in one third of patients, circulating tumour cells are undetected by conventional methods. Aim of the study was to assess the prognostic value of circulating tumour cells expressing mesenchymal markers in metastatic breast cancer patients. We isolated CTC from blood of 55 metastatic breast cancer patients. CTC were characterized for cytokeratins and markers of epithelial mesenchymal transition. The gain of mesenchymal markers in CTC was correlated to prognosis of patients in a follow-up of 24 months. The presence of mesenchymal markers on CTC more accurately predicted worse prognosis than the expression of cytokeratins alone. Because of the frequent loss of epithelial antigens by CTC, assays targeting epithelial antigens may miss the most invasive cell population. Thus, there is an urgent need to improve detection methods to identify CTC which undergone epithelial mesenchymal transition program.
authors.affiliation: Department of Molecular Medicine, Sapienza University, Viale Regina Elena, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Gradilone
authors.forename: Cristina
authors.initials: C
authors.lastname: Raimondi
authors.forename: Chiara
authors.initials: C
authors.lastname: Nicolazzo
authors.forename: Arianna
authors.initials: A
authors.lastname: Petracca
authors.forename: Orietta
authors.initials: O
authors.lastname: Gandini
authors.forename: Bruno
authors.initials: B
authors.lastname: Vincenzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Naso
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Aglianò
authors.forename: Enrico
authors.initials: E
authors.lastname: Cortesi
authors.forename: Paola
authors.initials: P
authors.lastname: Gazzaniga
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology*; D002469:Cell Separation; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D006801:Humans; D007633:Keratins / Q000097:blood*; D017493:Leukocyte Common Antigens / Q000097:blood; D008648:Mesoderm / Q000166:cytology / Q000378:metabolism*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011379:Prognosis
chemical_list: D007633:Keratins; D017493:Leukocyte Common Antigens