Annals of Oncology Advance Access originally published online on June 21, 2005
Annals of Oncology 2005 16(11):1845-1846; doi:10.1093/annonc/mdi350
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© 2005 European Society for Medical Oncology
Letter to the Editor |
Reply to the Letter to the Editor "Limitations of molecular detection of CK19 mRNA-positive cells in the peripheral blood of breast cancer patients with histologically negative axillary lymph nodes" by V. Pitini et al. (Ann Oncol 2005; 16: 1845)
First, some of the circulating tumor cells detected by the nested RT–PCR method specific for CK-19 mRNA could be apoptotic and the method is certainly not able to distinguish between non-viable and clonogenic cancer cells. However, the detection of these cells has been shown to correlate with clinical outcome [1
, 2]. Moreover, other investigators have demonstrated that these cells have a proliferative potential in cultures, which is also of clinical significance [3, 4]. Taken together, I believe that the present evidence suggests that although some of the tumor cells may very well be apoptotic, other circulating tumor cells are viable and able to proliferate.
Secondly, we agree that false-positive results from illegitimate expression of CK19 or expression of pseudogenes cannot be ruled out using this detection method. This is acknowledged in our reference publication [1], which is cited in the article as reference number 19.
University of Crete, PO Box 1352, 71110 Heraklion, Crete, Greece
* E-mail: stath{at}med.uoc.gr
References
1. Stathopoulou A, Vlachonikolis I, Mavroudis D et al. Molecular detection of cytokeratin-19-positive cells in the peripheral blood of patients with operable breast cancer: evaluation of their prognostic significance. J Clin Oncol 2002; 20: 3404–3412.
2. Xenidis N, Vlachonikolis I, Mavroudis D et al. Peripheral blood circulating cytokeratin-19 mRNA-positive cells after the completion of adjuvant chemotherapy in patients with operable breast cancer. Ann Oncol 2003; 14: 849–855.
3. Solakoglu O, Maierhofer C, Lahr G et al. Heterogeneous proliferative potential of occult metastatic cells in bone marrow of patients with solid tumors. Proc Natl Acad Sci 2002; 99: 2246–2251.
4. Piegra JY, Bonneton C, Magdelenat H et al. Clinical significance of proliferative potential of occult metastatic cells in bone marrow of patients with breast cancer. Br J Cancer 2003; 89: 539–545.[CrossRef][Medline]
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