Skip to main content
Journal of Cancer Research and Clinical Oncology logoLink to Journal of Cancer Research and Clinical Oncology
. 1996 Nov;122(11):679–686. doi: 10.1007/BF01209032

Reverse transcriptase/polymerase chain reaction detection of cytokeratin-19 mRNA in bone marrow and blood of breast cancer patients

William Krüger 1,, Cordula Krzizanowski 1, Michael Holweg 2, Marcus Stockschläder 1, Nicolaus Kröger 1, Roman Jung 3, Klaus Mross 4, Walter Jonat 2, Axel R Zander 1
PMCID: PMC12201216  PMID: 8898979

Abstract

A two-step reverse-transcriptase-based polymerase chain reaction (PCR) with nested primer pairs was developed to amplify sensitive and specific cytokeratin-19 (CK-19) mRNA sequences from human breast cancer cells. No CK-19 pseudogene interference was seen. The larger DNA-derived amplification products could be clearly discriminated from mRNA-derived products. The CK-19 message was not amplified from bone marrow or blood of healthy volunteers and patients with haematological malignancies nor from myeloid and lymphoid cell lines. Breast cancer cells were diluted in buffy coat cells up to 10−6 and CK-19 mRNA sought by PCR. The CK-19 message was detected in 14 of 26 blood samples and 14 of 24 marrow samples but in neither of two peripheral blood stem cell samples taken from 35 breast cancer patients. By sequence-analysis control of two of these samples and two cell lines, the amplified DNA fragments were confirmed to be homologous with the CK-19 sequence. The CK-19 message was further sought in matched blood/marrow samples taken from 13 untreated women in the same cohort at the time of diagnosis. In 3 of these, CK-19 RNA was detected in blood and marrow and, in 3 others, only in blood, but never in marrow alone. The results show that CK-19 assay by reverse transcriptase/PCR is a sensitive and specific technique for the detection of cancer cells in bone marrow and blood. It could be helpful in diagnosis and monitoring of metastatic breast cancer and detection of micrometastases. This should be evaluated on larger numbers of patients, with different clinical samples and epithelial malignancies.

Key words: Micrometastases, Minimal residual disease, RT-PCR, Breast cancer

Abbreviations

CK-19

cytokeratin 19

RT-PCR

reverse transcriptase/polymerase chain reaction

PBSC

peripheral blood stem cell

References

  1. Antman K, Ayash L, Elias A, Wheeler C, Hunt M, Eder JP, Teicher BA Critchlow J, Bibbo J, Schnipper LE, Frei E (1992) A phase II study of high-dose cyclophosphamide, thiotepa, and carboplatin with autologous marrow support in women with measurable advanced breast cancer responding to standard-dose therapy. J Clin Oncol 10:102–110 [DOI] [PubMed] [Google Scholar]
  2. Bader BL, Magin TM, Hatzfeld M, Franke WW (1986) Amino acid sequence and gene organization of cytokeratin no. 19, an exceptional tail-less intermediate filament protein. EMBO J 5:1865–1875 [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bártek J, Bártkova J, Schneider J, Taylor-Papadimitriou J, Kovarik J, Rejthar A (1986) Expression of monoclonal antibody-defined epitopes of keratin 19 in human tumours and cultured cells. Eur J Cancer Clin Oncol 22:1441–1452 [DOI] [PubMed] [Google Scholar]
  4. Bonadonna G, Valagussa P (1981) Dose-response effect of adjuvant chemotherapy in breast cancer. N Engl J Med 304:10–15 [DOI] [PubMed] [Google Scholar]
  5. Burchill SA, Bradbury MF, Pittman K, Southgate J, Smith B, Selby P (1995) Detection of epithelial cancer cells in peripheral blood by reverse transriptase-polymerase chain reaction. Br J Cancer 71:278–281 [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chomczynski P, Sacchi N (1987) Single-step method of RNA-isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem 162:156–159 [DOI] [PubMed] [Google Scholar]
  7. Cote RJ, Rosen PP, Old LJ, Osborne MP (1991) Prediction of early relapse in patients with operable breast cancer by detection of occult bone marrow micrometastasis. J Clin Oncol 9:1749–1756 [DOI] [PubMed] [Google Scholar]
  8. Crescenzi M, Seto M, Herzig GP, Weiss PD, Griffith RC, Korsmeyer SJ (1988) Thermostable DNA polymerase chain amplification of t(14;18) chromosome breakpoints and detection of minimal residual disease. Proc Natl Acad Sci USA 85:4869–4873 [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Datta YH, Adams PT, Drobyski WR, Either SP, Terry VH, Roth MS (1994) Sensitive detection of occult breast cancer by the reverse-transcriptase polymerase chain reaction. J Clin Oncol 12:475–482 [DOI] [PubMed] [Google Scholar]
  10. Dearnaley DP, Omerod MG, Sloane JP (1991) Micrometastases in breast cancer: Long-term follow-up of the first patient cohort. Eur J Cancer 27:236–239 [DOI] [PubMed] [Google Scholar]
  11. Diel IJ, Kaufmann M, Goerner R, Costa SD, Kaul S, Bastert G (1992) Detection of tumour cells in bone marrow of patients with primary breast cancer: A prognostic factor for distant metastasis. J Clin Oncol 10:1534–1539 [DOI] [PubMed] [Google Scholar]
  12. Eiermann W, Harbeck N, Untch M (1990) Möglichkeiten der Immunzytochemie am Beispiel der Knochenmarkaspiration-szytologie bei Mammakarzinompatientinnen. Gynäkologe 23:358–364 [PubMed] [Google Scholar]
  13. Gerhard M, Juhl H, Kalthoff H, Schreiber HW, Wagener C, Neumaier M (1994) Specific detection of carcinoembryonic antigen-expressing tumor cells in bone marrow aspirates by polymerase chain reaction. J Clin Oncol 12:725–729 [DOI] [PubMed] [Google Scholar]
  14. Harris JR, Lippman ME, Veronesi U, Willett W (1992) Breast Cancer. [parts I, II, III. N Engl J Med 327:319–328, 390–398, 473–480 [DOI] [PubMed] [Google Scholar]
  15. Innis MA, Gelfand DH, Sninsky J, White TJ (1989) PCR-protocols. A guide to methods and applications. Academic Press, New York [Google Scholar]
  16. Joshi SS, Kessinger A, Mann SL, Stevenson M, Weisenburger DD, Vaughan WP, Armitage JO, Sharp JG (1987) Detection of malignant cells in histologically normal bone marrow using culture techniques. Bone Marrow Transpl 1:303–310 [PubMed] [Google Scholar]
  17. Krüger WH, Stockschläder M, Zander AR (1994) Detection of epithelial specific RNA in blood and bone marrow with a RT-based polymerase chain reaction. Proc Annu Meet Am Soc Clin Oncol 13:A74 [Google Scholar]
  18. Maniatis T, Fritsch EF, Sambrook J (1989) Molecular cloning: a laboratory manual. Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY [Google Scholar]
  19. Moll R, Franke WW, Schiller DL, Geiger B, Krepler R (1982) The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell 31:11–24 [DOI] [PubMed] [Google Scholar]
  20. Mullis KB, Faloona FA (1987) Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Methods Enzymol 155:335–350 [DOI] [PubMed] [Google Scholar]
  21. Neville AM (1991) Breast cancer micrometastases in lymph nodes and bone marrow are prognostically important. Ann Oncol 2:13–14 [DOI] [PubMed] [Google Scholar]
  22. Ponte P, Ng SY, Engel J, Gunning P, Kedes L (1984) Evolutionary conservation in the untranslated regions of actin mRNAs: DNA sequence of a human beta-actin cDNA. Nucleic Acids Res 12:1687–1696 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Ross AA, Cooper BW, Lazarus HM, MacKay W, Moss TJ, Ciobanu N, Tallman MS, Kennedy MJ, Davidson N, Sweet DS, Winter C, Jansen J, Akard L, Copelan E, Kahn DG, Warner NE (1992) Comparison of tumor cell contamination in peripheral blood stem cell collections (PBSC) and bone marrow (BM) in patients with advanced breast cancer (ABC) using immunocytochemistry (ICC): evidence for clonogenicity of occult metastases. Blood 80:235a1535239 [Google Scholar]
  24. Savtchenko ES, Schiff TA, Jiang CK, Freedberg IM, Blumenberg M (1988) Embryonic expression of the human 40-kD keratin: evidence from a processed pseudogene sequence. Am J Hum Genet 43:630–637 [PMC free article] [PubMed] [Google Scholar]
  25. Schlimok G, Funke I, Holzmann B, Göttlinger G, Schmidt G, Häuser H, Swierkot S, Warnecke HH, Schneider B, Koprowsky H, Riethmüller G (1987) Micrometastatic cancer cells in bone marrow: In-vitro detection with anti-cytokeratin and in-vivo labeling with anti-17-1A monoclonal antibodies. Proc Natl Acad Sci USA 84:8672–8676 [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Schoenfeld A, Luqmani Y, Smith D, O'Reilly S, Shousha S, Sinett HD, Coombes RD (1994) Detection of breast cancer micrometastases in axillary lymph nodes by using polymerase chain reaction. Cancer Res 54:2986–2990 [PubMed] [Google Scholar]
  27. Sharp JG, Vaughan WP, Kessinger A, Mann SL, DeBoer JM, Sanger WG, Weisenburger DD (1990) Significance of detection of tumor cells in hematopoetic stem cell harvests of patients with breast cancer. In: Dicke KA et al. (eds) Proceedings of the 5th International. Symposium on Autologous Bone Marrow Transplantation. The University Medical Center, Omaha, NE [Google Scholar]
  28. Smith B, Selby P, Southgate J, Pittman K, Bradley C, Blair GE (1991) Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction. Lancet 338:1227–1229 [DOI] [PubMed] [Google Scholar]
  29. Stasiak PC, Lane EB (1987) Sequence of cDNA coding for human keratin 19. Nucleic Acids Res 15:10058 [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Tracy TE, Mulcahy LS (1991) A simple method for direct automated sequencing of PCR fragments. Biotechniques 11:68 [PubMed] [Google Scholar]
  31. Van de Vijver M, Nusse R (1991) The molecular biology of breast cancer. Biochim Biophys Acta 1072:33–50 [DOI] [PubMed] [Google Scholar]
  32. Williams SF, Gilewski T, Mick R, Bitran JD (1992) High-dose consolidation therapy with autologous stem cell rescue in stage IV breast cancer: Follow-up report. J Clin Oncol 10:1743–1747 [DOI] [PubMed] [Google Scholar]

Articles from Journal of Cancer Research and Clinical Oncology are provided here courtesy of Springer

RESOURCES