Department of Anesthesia, Peking University Third Hospital, Huayuan 49# Rd, Haidian Dist., Beijing, China.
Biological Sample Bank, Peking University Third Hospital, Beijing, China.
BMC Urol. 2021 Jun 10;21(1):89. doi: 10.1186/s12894-021-00803-w.
Intra-operative cell salvage (IOCS) and leukocyte-depleted filter (LDF) are widely used and effective in saving blood. However, the safety issue concerning reinfusion of IOCS-LDF processed blood to renal cell carcinoma (RCC) patients with inferior vena cava (IVC) thrombus were inconclusive for fear of increased risk of cancer metastases. This study intends to analyze the circulating tumor cell (CTC) eliminating effect of IOCS-LDF in 5 RCC-IVC thrombus patients.
A novel strategy integrating negative enrichment by immunomagnetic beads and immunostaining-fluorescence in situ hybridization with probes identifying aneuploid of 8 and/or 7 were used to detect CTCs from salvages blood. Blood samples were collected from 4 stages in each patient.
Of the 5 RCC patients, the number of CTCs decreased (from 3, 4, 10, 7, 3, respectively, to all zero) after IOCS-LDF treatment. The triploid of chromosome 7 and/or chromosome 8 were most common karyotype for RCC patients with IVC thrombus. Tetraploid of chromosome 8 occurred in only one sample and no polypoid (number of chromosome > 4) were found.
IOCS-LDF might be a promising way of reducing of allogeneic product transfusion based on current preliminary outcome. More convincing conclusions are to be drawn with enlarged sample size and long-term follow-up for patients prognosis.
术中细胞回收（IOCS）和白细胞滤除器（LDF）在血液保存方面应用广泛且效果显著。然而，由于担心增加癌症转移的风险，对于将 IOCS-LDF 处理后的血液回输给合并下腔静脉（IVC）血栓的肾细胞癌（RCC）患者的安全性问题尚无定论。本研究旨在分析 IOCS-LDF 对 5 例合并 IVC 血栓的 RCC 患者循环肿瘤细胞（CTC）的清除效果。
采用免疫磁珠阴性富集和免疫染色-荧光原位杂交技术，结合识别非整倍体 8 和/或 7 的探针，对回收血液中的 CTC 进行检测。从每位患者的 4 个阶段采集血液样本。
5 例 RCC 患者中，IOCS-LDF 治疗后 CTC 数量减少（分别为 3、4、10、7、3，均降至零）。染色体 7 和/或 8 的三倍体是合并 IVC 血栓的 RCC 患者最常见的核型。仅在一个样本中发现了染色体 8 的四倍体，没有发现多倍体（染色体数>4）。
基于目前的初步结果，IOCS-LDF 可能是减少同种异体产品输注的一种有前途的方法。需要扩大样本量并对患者进行长期随访以评估预后，从而得出更有说服力的结论。
