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Der Urologe

, Volume 53, Issue 4, pp 501–508 | Cite as

Zirkulierende Tumorzellen im peripheren Blut beim Urothelkarzinom der Harnblase

Detektion und Stellenwert
  • M. Rink
  • A. Soave
  • O. Engel
  • M. Fisch
  • S. Riethdorf
  • K. Pantel
Leitthema

Zusammenfassung

Zirkulierende Tumorzellen (CTC) spielen eine entscheidende Rolle im natürlichen Erkrankungsverlauf maligner Erkrankungen und sind Gegenstand intensiver wissenschaftlicher Untersuchungen. Dieser Übersichtsartikel fasst die gegenwärtige Literatur zum Stellenwert von CTC im peripheren Blut bei Patienten mit einem Urothelkarzinom der Harnblase zusammen. Obgleich verschiedene Methoden zur Detektion und Isolierung von CTC zur Verfügung stehen, wurde in den letzten Jahren überwiegend das standardisierte und von der „Food and Drug Administration“ zugelassene CellSearch®-Verfahren verwendet, das einen direkten CTC-Nachweis ermöglicht. Die Mehrheit aller Studien beim Urothelkarzinom konnte keine Korrelation zwischen CTC-Nachweis und klinischen oder histopathologischen Parametern feststellen. Dennoch konnten mehrere Arbeiten zeigen, dass CTC ein unabhängiger Risikofaktor für einen ungünstigen Erkrankungsverlauf darstellen. CTC im peripheren Blut sind leicht zugänglich und repräsentieren dadurch einen hoffnungsvollen Biomarker für ein zukünftig effektiveres klinisches Monitoring des Therapieerfolgs bzw. -ansprechens. CTC können potentiell zur Individualisierung und Optimierung des Zeitpunkts einer radikalen Zystektomie sowie für die Patientenberatung bezüglich einer (neo)adjuvanten Chemotherapie eingesetzt werden.

Schlüsselwörter

Outcome Blasenkarzinom Biomarker Zystektomie, radikale Chemotherapie 

Tumor cells in the peripheral blood of patients with urothelial carcinoma of the bladder

Detection and impact of circulating

Abstract

Circulating tumor cells (CTC) play a crucial role in the natural history of several malignancies and, thus, are the subject of intense research efforts. This review summarizes the most contemporary literature data regarding detection of CTC and their impact on the oncological prognosis of patients with urothelial carcinoma of the bladder (UCB). Despite the availability of different methods for CTC detection and isolation in the peripheral blood, the standardized and Food and Drug Administration-approved CellSearch® assay is currently the most commonly used system for CTC detection. The majority of studies did not find any association between presence of CTC and clinicopathologic features. However, CTC have been demonstrated to represent a strong, independent predictor for unfavorable oncological outcomes in UCB. Since the peripheral blood is an easily accessible source, CTC represent a promising biomarker to effectively monitor early disease progression and therapy response in the near future. CTC hold the potential to individualize patient counseling regarding the optimal timing of radical surgery or bladder-sparing treatment as well as multimodal therapies.

Keywords

Treatment outcome Bladder neoplasms Biomarkers Cystectomy, radical Chemotherapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. Michael Rink, Armin Soave, Oliver Engel, Margit Fisch, Sabine Riethdorf und Klaus Pantel geben an, dass kein Interessenkonflikt besteht. Dr. med. Michael Rink wird durch das GEROK Stipendium der Universität Hamburg gefördert. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • M. Rink
    • 1
  • A. Soave
    • 1
  • O. Engel
    • 1
  • M. Fisch
    • 1
  • S. Riethdorf
    • 2
  • K. Pantel
    • 2
  1. 1.Klinik und Poliklinik für UrologieUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland
  2. 2.Institut für TumorbiologieUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland

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