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UROLOGIC ONCOLOGY

Immunomagnetic quantification of circulating tumoral cells in patients with prostate cáncer: Clinical and pathological correlation.
L. Resel Folkersman, C. Olivier Gomez, L. San Jose Manso, S. Veganzones de Castro,I. Galante Romo, M. Vidaurreta Lazaro, G.V. de la Orden, M. Arroyo Fernandez, E. Diaz Rubio, A. Silmi Moyano and M. A. Maestro de las Casas.

JOURNAL
Tomo 63. Número 01 - Enero-Febrero 2010

REFERENCE
Arch. Esp. Urol. 2010; 63 (1): 23-31

KEYWORDS
Circulating. Immunomagnetic enrich-ment. Metastatic carcinoma. Prostatic carcinoma. Tumoral cells.

OBJECTIVES
To detect and enumerate circulating prostatic tumor cells (CTC) in the peripheral blood of patients with prostate cancer (PC) and study the relationship between CTCs and clinical-pathological parameters.

METHODS
Prospective three-arm study: 26 patients (p) with localised PC (LPC); 24 P with metastatic PC (MPC) and 30 healthy volunteer controls. A single 7.5 ml sample of peripheral blood was retrieved; CTCs were isolated using an immunomagnetic method based on the CellSearch system (Veridex). CTCs were identified as nucleated cells negative for CD45 (leukocytes) and positive for cytokeratins. (8, 18 y 19) The relationship between CTC numbers and PSA levels, Gleason score and TNM classification was studied.

RESULTS
Only 10% of the healthy controls had 1 CTC/7.5 mL, none of the patients with localised PC had more than 3 CTCs (88% ? 2 CTCs), and patients with MPC had significantly higher CTC levels [m: 29 (1-178)] compared with the other two groups (P: 0.000). A positive correlation was demonstrated between the CTC count and PSA levels, tumor size, and presen-ce or absence of enlarged lymph nodes. Gleason score was the only parameter that did not show any correlation with CTC levels, and although the number of CTCs was higher in patients with visceral metasta-ses [m: 297 (0-416)] compared with bone metastases patients [m: 68 (9.5-168)], these differences were not significant.

CONCLUSIONS
Immunomagnetic analysis permits CTCs to be enumerated in peripheral blood and could be a possible way to correctly stage and make a reaso-nable prognosis of metastatic disease.




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