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Title   유방암 환자에서 AE1 / AE3 단크론 항체를 이용한 골수미세전이세포의 검출 ( Immunofluorescent Monoclonal Antibody ( AE1 / AE3 ) Detection of Bone Marrow Micrometastasis with Primary Breast Cancer )
Publicationinfo   1993 Jan; 025(06): 912-920.
Key_word   Breast Cancer, Micrometastasis, Monoclonal antibody, Immunofluorescence
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Abstract   The most common site of dissemination of breast cancer is to the bony skeleton via the bone marrow and conventional diagnostic modalities including bone scanning, skeletal radiography and alkaline phosphatase at the time of initial treatment fail to identify those patients who are going to relapse. There have been many reports that an occult micrometastasis could be detected in the bone marrow of breast cancer patients using a epithelial specific monoclonal antibodies in an indirect immunofluorescent assay. Using a monoclonal antibody(AE1/AE3) against cytokeratin, occult tumor cells in the bone marrow of breast cancer patients(n=47) were iden- tified at the time of surgery. The aim of the present study was to evaluate the significance of the presence of tumor cells in the bone marrow of patients with primary breast cancer in rela- tion to other prognostic factors. Of the 47 patient who entered the study between July 1991 and June 1992, 14(29.8%) were found to have tumor cells in their bone marrow. No significant dif- ferences in the percentage of patients with antigen positive cells were recorded between the node positive(33.3%) and node negative(27.6%) groups. Fourteen percent of T1,30.8% of T2, and 57.1% of T, displayed positive bone marrow results. Significant correlations were found between tumor cell detection and tumor size. According to the stage, 18.2% of patient with stage I, 30% of patients with stage II, 40% of patient with stage III, and 100% of patient with stage IV had extrinsic cells, but these trends did not reach the level of the statistical significance in this small number of patients. A relationship was found between the presence of micrometastasis and peritumoral lymphatic invasion but not peritumoral vascular invasion within the primary tumor, histological grade, nuclear grade, mitotic index and menopausal status were not related with presence of micrometastasis. During the medium duration of 1 year follow up, 3 of 13 patients with micrometastasis recurred at distant site, while one of 33 without micrometastasis showed a recurrence at ipsilateral axillary lymph node. These results suagest that detection of occult micrometastasis provides one of the significant predictors of relapse and prognosis and guideline for the intensive adjuvant chemotherapy especially for the node negative patients.
저 자   정진식(Jin Sik Chung),이수정(Soo Jung Lee),권굉보(Koing Bo Kwun)