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KMID : 0371320000590040447
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Journal of the Korean Surgical Society
2000 Volume.59 No. 4 p.447 ~ p.457
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Use of RT-PCR for Cytokeratin 19 to Detect Micrometastases in Bone Marrow of Follow-up Patients with Breast Cancer after Surgery
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이민혁/Min Hyuk Lee
임철완/서원석/조규석/신응진/전희정/홍대식/Cheol Wan Lim/Won Suk Suh/Kyu Suk Jo/Eung Jin Shin/Hee Jung Cheon/Dae Sik Hong
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Abstract
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Purpose: We have previously reported that the reverse transcriptase-polymerase chain reaction (RT-PCR) for cytokeratin 19 (CK 19) is a highly sensitive and specific method for detecting micrometastases in the bone marrow of patients with primary
breast
cancer. Thus, we conducted this study to identify occult metastatic cells in the bone marrow of follow-up patients with breast cancer by using the RT-PCR for cytokeratin 19 after surgery. Methods: We studied 42 patients with breast cancer who had
no
evidence of relapse, 3 patients who had a local relapse, and 7 patients who had distant metastases. Bone-marrow aspirates were taken from the single posterior iliac crest under local anesthesia anesthesia at a median of 45 months after surgery.
RT-PCR
for CK19 was done by using two 30-cycle rounds with nested primers. Results: Occult metastases were found in 23% of the 52 breast-cancer patients. None of the bone-marrow aspirates showed any evidence of tumor involvement by using conventional
cytology.
RT- PCR was positive for CK 19 in 19% of the 42 patients without relapse, and in 40% of the 10 patients with local or distant relapse. Conclusion: RT-PCR for CK 19 is a sensitive method for detecting tumor cells in the bone marrow of follow-up
patients
with breast cancer after surgery. This assay may be useful in detecting metastastic disease, as well as in monitoring the effectiveness of systemic therapy. However, a large study with long-term follow-up is required in order to clarify its
clinical
significance and usefulness.
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KEYWORD
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