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Detektion zirkulierender Tumorzellen im peripheren Blut beim Prostatakarzinom

Detection of circulating tumor cells from peripheral blood in prostate cancer

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Zusammenfassung

Zirkulierende Tumorzellen („circulating tumor cells“, CTC) können mit sensitiven immunzytochemischen und molekularen Methoden detektiert werden und können Fernmetastasen bewirken. Konsekutiv konnte die prognostische Wertigkeit der CTC für das Überleben beim metastasierten Prostatakarzinom demonstriert werden. Hierbei ist ein CTC-Schwellenwert von < 5 vs. ≥ 5 CTC den bekannten PSA-Algorithmen prognostisch überlegen. Hingegen ist bei Patienten mit lokalisiertem Prostatakarzinom die klinische Wertigkeit der CTC umstritten. Des Weiteren könnten CTC einen prädiktiven Marker für den Therapieerfolg darstellen, da sie die heterogene molekulare Signatur sowohl des Tumors als auch der Metastasen aufweisen können. Folglich könnten CTC, nicht nur als prognostischer Marker, sondern auch als „liquid biopsy“ ein Zugang zu personalisierten Therapiestrategien sein. In dieser Übersichtsarbeit wird stadienübergreifend die klinische Anwendung der CTC diskutiert.

Abstract

Circulating tumor cells (CTCs) can be detected with sensitive immunocytological and molecular methods and can potentially cause distant metastases. Consecutively the prognostic significance of CTC-counts for survival was demonstrated in metastatic prostate cancer (mPC) revealing CTCs as reliable surrogate marker during therapy. Comparatively the prognostic value of a CTC-threshold with < 5 vs. ≥ 5 CTCs was superior to the commonly used PSA-decrement algorithms. In contrast despite evidence of CTCs in localized PC, their clinical value in this stage is currently precarious. Furthermore, CTCs may serve as predictive markers with the ability to predict treatment sensitivity or resistance, since they may represent the heterogeneous molecular signature of primary as well as metastatic cancer lesions. Thus, the isolation of CTCs may serve not only as a prognostic tool but moreover as a liquid biopsy and a window towards personalized treatment. This review discusses the clinical impact of CTCs in the different stages of PC.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Thalgott, M.M. Heck und K. Pantel geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland

    M. Thalgott & M.M. Heck

  2. Institut für Tumorbiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    K. Pantel

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  1. M. Thalgott
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  2. M.M. Heck
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  3. K. Pantel
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Correspondence to M. Thalgott.

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Mark Thalgott und Matthias M. Heck haben gleichermaßen zu dieser Arbeit beigetragen.

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Thalgott, M., Heck, M. & Pantel, K. Detektion zirkulierender Tumorzellen im peripheren Blut beim Prostatakarzinom. Urologe 53, 509–513 (2014). https://doi.org/10.1007/s00120-014-3444-1

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  • DOI: https://doi.org/10.1007/s00120-014-3444-1

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