[Bone marrow isolated micrometastases of non-small cell lung cancer].

UNLABELLED

The ability to detect occult systemic metastases in patients with operable NSCLC could have a significant impact on the management of the disease. The aim of the study was to detect occult micrometastatic tumor cells in bone marrow in patients with resectable NSCLC.

MATERIAL AND METHODS

A total of 35 patients (29 men, 6 women), age between 47 and 78 (mean 61.6) were included in the study. In each of the patients bone marrow aspirates from the ribs were sampled during surgery. Both the tumor and the bone marrow aspirate were examined histologically and immunocytochemically with the cytokeratin: AE1/AE3, CAM 5,2, CK-7, CK-18. The presence of grow factors CD 31 and CD 34 were examined as well.

RESULTS

No evidence of micrometastases or tumor cells in bone marrow was found in histological examination. Cytokeratin positive (CAM 5,2 +) cells were detected in 33 cases (94.23%) of the tumors and in 21 cases (60.00%) of bone marrow samples. The statistically significant correlation between the presence of CAM 5,2 in tumors and bone marrow was found (p = 0.049). Cytokeratin positive cells were detected in all the 35 tumors (AE1/AE3), in 20 tumors--57.14% (CK-7) and in 23 tumors--65.71% (CK-18). Cytokeratin positive cells (CK-7) were detected in bone marrow sample in one patient only.

CONCLUSIONS

Immunocytochemical examination with the use of cytokeratin CAM 5,2 is of use to detect occult micrometastatic tumor cells in bone marrow in NSCLC patients. However, no correlations were found between the presence of cytokeratin CAM 5,2 in bone marrow or tumor and patients' age, sex and the histological type of NSCLC its degree of malignancy and stage.