Macadam Robert, Sarela Abeezar, Wilson Jonathan, MacLennan Kenneth, Guillou Pierre
Department of Surgery, St James' University Hospital, Leeds, UK.
Eur J Surg Oncol. 2003 Jun;29(5):450-4. doi: 10.1016/s0748-7983(03)00029-5.
Tumour cells in the bone marrow of patients with gastrointestinal cancer may detect patients at higher risk of disease recurrence and death following potentially curative surgery.
Immunocytochemistry using the monoclonal antibody Ber-EP4, which detects tumour cells from squamous and adenocarcinomas was used. In preliminary spiking experiments to define sensitivity, tumour cells were detected in blood at 10(3)/ml. Bone marrow samples from 74 patients with oesophago-gastric cancer and from 14 control patients was examined.
27 (36.5%) patients with cancer and one control patient had stained cells present in their bone marrow at the time of resection. During the follow up period (mean 14 months), relapse and disease-specific death were commoner in patients whose marrow contained tumour cells. Multivariate analysis confirmed bone marrow micrometastasis as an independent prognostic variable for both recurrence and survival.
Bone marrow immunocytochemistry using Ber-EP4 may identify those patients at highest risk of early relapse following RO resection of oesophageal or gastric cancer.
胃肠道癌患者骨髓中的肿瘤细胞可能会识别出在接受潜在根治性手术后疾病复发和死亡风险较高的患者。
采用免疫细胞化学方法，使用单克隆抗体Ber-EP4，该抗体可检测鳞状细胞癌和腺癌中的肿瘤细胞。在初步加样实验以确定敏感性时，在血液中以10(3)/ml的浓度检测到肿瘤细胞。检查了74例食管胃癌患者和14例对照患者的骨髓样本。
27例（36.5%）癌症患者和1例对照患者在切除时骨髓中有染色细胞。在随访期（平均14个月）内，骨髓中含有肿瘤细胞的患者复发和疾病特异性死亡更为常见。多变量分析证实骨髓微转移是复发和生存的独立预后变量。
使用Ber-EP4进行骨髓免疫细胞化学检查可能会识别出那些在食管癌或胃癌RO切除术后早期复发风险最高的患者。
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