Bjørnland Kristin, Flatmark Kjersti, Mala Tom, Mathisen Oystein, Bakka Arne, Aasen Ansgar O, Bergan Anstein, Søreide Odd, Fodstad Oystein
Surgical Department, Rikshospitalet, University Hospital, Oslo, Norway.
J Surg Oncol. 2003 Apr;82(4):224-7. doi: 10.1002/jso.10223.
In colorectal cancer (CRC) patients, tumour recurrence is common following potentially curative surgery for liver metastases. This may be caused by occult tumour cells present at the time of surgery. Dissemination of micrometastatic cells may occur early in patients with solid cancer, and micrometastases may signify a poor prognosis. The aim of the present study was to evaluate the frequency of micrometastatic cells in the bone marrow of patients with potentially resectable liver metastases.
Twenty millilitres of bone marrow was aspirated from both anterior iliac crests from 48 patients. Mononuclear cells were isolated and incubated with superparamagnetic Dynabeads coated with an anti-epithelial monoclonal antibody (MOC31). Magnetically selected cells were identified by light microscopy as cells with bead rosettes (>5 beads/cell).
Micrometastatic tumour cells were identified in four of 48 (8%) patients who all had their liver metastases surgically removed. Two of the four died after 17 and 18 months, respectively, whereas two are alive after 10 and 12 months. None of the 19 inoperable patients had micrometastases.
The frequency of bone marrow micrometastases in patients with clinically isolated liver metastases from CRC was low. This is biologically interesting, but bone marrow status should not affect current treatment protocols.
在结直肠癌（CRC）患者中，对于肝转移灶进行潜在根治性手术后，肿瘤复发很常见。这可能是由手术时存在的隐匿肿瘤细胞引起的。实体癌患者可能在早期就发生微转移细胞的播散，且微转移可能预示预后不良。本研究的目的是评估具有潜在可切除肝转移灶的患者骨髓中微转移细胞的频率。
从48例患者的双侧髂前嵴抽取20毫升骨髓。分离单核细胞，并与包被有抗上皮单克隆抗体（MOC31）的超顺磁性Dynabeads一起孵育。通过光学显微镜将磁性选择的细胞鉴定为具有珠状玫瑰花结（>5个珠子/细胞）的细胞。
48例患者中有4例（8%）被鉴定出存在微转移肿瘤细胞，这4例患者均接受了肝转移灶的手术切除。其中2例分别在17个月和18个月后死亡，而另外2例在10个月和12个月后仍存活。19例不可手术的患者均未发生微转移。
CRC临床孤立性肝转移患者骨髓微转移的频率较低。这在生物学上很有趣，但骨髓状态不应影响当前的治疗方案。
