Mashhad University of Medical Sciences, Thoracic Surgery Department, Ghaem Hospital, Ahmadabad Street, Mashhad, Iran.
Eur J Cardiothorac Surg. 2011 Aug;40(2):343-6. doi: 10.1016/j.ejcts.2010.12.029. Epub 2011 Feb 22.
Behaviors of esophageal cancer are different according to the geographic distribution. The prevalence of bone marrow involvement in patients with esophageal cancer has been shown to be between 40% and 90%, but clinical correlation is unknown. The aim of this study is to determine the rate of bone marrow involvement in patients with esophageal cancer in the northeast of Iran and its relationship with clinicopathologic findings of the tumors.
A total of 43 patients with esophageal cancer, who were candidates for esophagectomy (without neo-adjuvant chemotherapy), were enrolled in this study from 2007 to 2009. Bone marrow samples derived from rib bone were stained with hematoxylin and eosin (H&E) to distinguish tumoral cells, and cytokeratin immunohistochemistry (CKIHC) was used to determine micrometastasis. The correlation of the results was studied with the histopathologic indices of primary tumor (T (tumor), N (node) and length of tumoral involvement and grading) as well as characteristics of the patients (sex and age).
The mean age was 64 (57-70) years and the M/F ratio was 2.9. As many as 38 patients (88.4%) had squamous cell carcinoma and five patients (11.6%) had adenocarcinoma. In nine cases (20.9%), the H&E test, and, in 13 cases (30.2%), the CKIHC evaluation was positive. Statistically, there was no relationship between the pathologic type and the stage of T with the H&E study and CKIHC test, respectively. On the other hand, a significant meaningful correlation was found between microscopic bone marrow involvement as well as mediastinal lymph node involvement and grade of the tumor.
Bone marrow involvement incidence was low in our geographic area. According to our study, bone marrow involvement in esophageal cancer is related to differentiation grade and mediastinal lymph node involvement.
食管癌的行为因地理位置而异。已有研究表明，食管癌患者骨髓受累的发生率在 40%至 90%之间，但临床相关性尚不清楚。本研究旨在确定伊朗东北部食管癌患者骨髓受累的发生率及其与肿瘤临床病理特征的关系。
本研究共纳入 2007 年至 2009 年间 43 名拟行食管癌切除术（无新辅助化疗）的食管癌患者。从肋骨采集骨髓样本，用苏木精和伊红（H&E）染色区分肿瘤细胞，并用细胞角蛋白免疫组织化学（CKIHC）检测微转移。研究结果与原发肿瘤的组织病理学指标（T（肿瘤）、N（淋巴结）、肿瘤受累长度和分级）以及患者的特征（性别和年龄）相关。
患者的平均年龄为 64 岁（57-70 岁），男女比例为 2.9。38 例（88.4%）为鳞状细胞癌，5 例（11.6%）为腺癌。9 例（20.9%）H&E 检测阳性，13 例（30.2%）CKIHC 评估阳性。分别从统计学上看，病理类型与 T 分期与 H&E 研究和 CKIHC 检测之间均无相关性。另一方面，显微镜下骨髓受累以及纵隔淋巴结受累与肿瘤分级之间存在显著的相关性。
在我们的地理区域，骨髓受累的发生率较低。根据我们的研究，食管癌骨髓受累与分化程度和纵隔淋巴结受累有关。
