The major cause of death in breast cancer patients is metastasis. Various
biomarkers have been used for the early detection of circulating tumor cells
in the peripheral blood of breast cancer patients. The aims of the current
study were to analyze circulating tumor cells in the blood of breast cancer
patients by investigating EGFR, CK19, CK20 and HER2 expression profiles and
to evaluate their prognostic importance.
Methods
CK19, CK20 and EGFR gene expression profiles were evaluated in the blood
samples of 84 female patients with primary invasive ductal breast cancer and
20 healthy female volunteers using SYBR green-based real-time qPCR assays.
HER2 expression analyses were conducted in 46 patients who had an
HER2-positive primary tumor and in 30 healthy women to determine the cutoff
level of positivity.
Results
The positive rates of CK20, EGFR, CK19 and HER2 mRNA expression in the
peripheral blood were 28.57% (24/84), 20.23% (17/84), 5.95% (5/84) and 2.17%
(1/46), respectively. The high positive ratio of CK20 mRNA expression in the
peripheral blood of breast cancer was identified for the first time in the
current study. Significant differences were identified in CK20 expression
status and several clinical parameters related with aggressiveness of tumors
using a binary logistic regression analysis. Higher CK20-positive levels
were observed in patients who had lymph node metastasis and advanced-grade
primary tumors, which were estrogen receptor-negative. We have demonstrated
that CK20 may be a novel biomarker that is useful to identify circulating
tumor cells and predict breast cancer progression.
Conclusions
The results suggest that the investigation of CK20 mRNA with other biomarkers
in the peripheral blood of breast cancer patients may be useful to monitor
the presence of disseminated tumor cells in the blood circulation and to
predict the prognosis of breast cancer.
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