The relevance of circulating epithelial tumor cells (CETC) for therapy monitoring during neoadjuvant (primary systemic) chemotherapy in breast cancer.

BACKGROUND: Having demonstrated in a previous report that the response of circulating epithelial tumor cells (CETC) during the first cycles of primary (neoadjuvant) chemotherapy perfectly reflects the response of the tumor, in the present study the changes in cell numbers during subsequent cycles and their possible impact on the therapy's outcome were examined. PATIENTS AND METHODS: In 58 breast cancer patients CETC were quantified during therapy with either EC (epirubicin/ cyclophosphamid) or dose intensified E (epirubicin) followed by taxane, with or without trastuzumab, and subsequent CMF (cyclophosphamid/methorexate/ fluorouracil). RESULTS: CETC numbers declined more than 10-fold (good response) in 65% (her2/neu-negative) and 55% (her2/neu-positive) of patients during EC, and in 60% during dose intensified E, respectively, followed by an increase of CETC in all patients. CETC remained increased, decreasing only when adding CMF. A good initial response correlated with estrogen-receptor negativity, a poor response with early distant relapse (P < 0,0001, hazard ratio = 11.91). CONCLUSION: Response of CETC already during the first cycles of neoadjuvant treatment predicts the final response of the tumor. Hitherto unknown effects of the release of tumor cells during therapy further our understanding of tumor-blood interaction and may improve access of agents like antibodies to cells. The impact on the further course of disease remains to be evaluated.

[Distribution of praevalent morphological symptoms of the oral complex in 600 Jena school children in dependence of age and sex (author's transl)]. / Häufigkeitsverteilung morphologischer Merkmale der Mundregion bei 600 Jenaer Schulkindern in Abhängigkeit von Alter und Geschlecht.

In this study praevalence and stage of some selected symptoms within the orofacial complex were investigated in 600 normal children living in Jena (300 boys and 300 girls). The first problem of this study consisted in registering the biological variability of 6 symptoms (bit abnormality, protrusion of the lower lip, diastema, palatal height, size of the tongue, fissured tongue) in a normal group, and secondly to find correlations between these symptoms. The results are listed for the age groups according to sex. The supposed causes that may lead to the development of these symptoms are discussed. Our results were compared with those of the literature. Difficulties and incompletion are involved in recording of the mentioned symptoms and their value of diagnosis.