Department of Thoracic Surgery, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Ann Thorac Med. 2012 Jul;7(3):149-52. doi: 10.4103/1817-1737.98848.
The clinical relevance of bone marrow micrometastasis (BMM) in non-small-cell lung cancer is undetermined, and the value of such analyses in advanced stage patients has not been clearly assessed previously. This study was conducted to estimate the accuracy of both polymerase chain reaction (PCR) and immunohistochemistry (IHC) in micrometastases detection and determine the best site for bone marrow biopsy in order to find micrometastasis.
This prospective cross-sectional study was performed in the Department of Thoracic Surgery, Alzahra University Hospital from September 2008 to June 2009. To evaluate the bone marrow, a 3-cm rib segment and an aspirated specimen from the iliac bone prior to tumor resection were taken. PCR and IHC were performed for each specimen to find micrometastasis.
Of 41 patients, 14 (34%) were positive for BMM by PCR compared with two positive IHC (4.8%). All BMMs were diagnosed in rib segments, and iliac specimens were all free from metastatic lesion. Our data showed no significant association between variables such as age, sex, histology, tumor location, side of tumor, involved lobe, smoking, or weight loss and presence of BMM.
PCR could use as a promising method for BMM detection. BMM in a sanctuary site (rib) is not associated with advanced stages of lung cancer. In addition, when predictor variables such as age, sex, histology, tumor location, smoking, or weight loss are analyzed, no correlation can be found between micrometastasis prevalence and any of those variables.
骨髓微转移（BMM）在非小细胞肺癌中的临床意义尚不确定，以前也没有明确评估此类分析在晚期患者中的价值。本研究旨在评估聚合酶链反应（PCR）和免疫组织化学（IHC）在微转移检测中的准确性，并确定进行骨髓活检的最佳部位以发现微转移。
这是一项前瞻性的病例对照研究，于 2008 年 9 月至 2009 年 6 月在阿尔扎赫拉大学医院胸外科进行。为了评估骨髓，在肿瘤切除前从肋骨的 3cm 节段和髂骨中抽取骨髓抽吸标本。对每个标本进行 PCR 和 IHC 以寻找微转移。
41 例患者中，14 例（34%）PCR 检测到 BMM，而 2 例 IHC 阳性（4.8%）。所有 BMM 均在肋骨段诊断，髂骨标本均无转移性病变。我们的数据显示，BMM 的存在与年龄、性别、组织学、肿瘤位置、肿瘤侧、受累肺叶、吸烟或体重减轻等变量之间没有显著相关性。
PCR 可作为检测 BMM 的一种很有前途的方法。避难所部位（肋骨）的 BMM 与肺癌晚期无关。此外，当分析年龄、性别、组织学、肿瘤位置、吸烟或体重减轻等预测变量时，无法发现微转移发生率与这些变量中的任何一个之间存在相关性。
