Müller M, Kuhn D F, Hinrichs B, Schindler E, Dreyer T, Hirsch C, Schäffer R, Hempelmann G
Abteilung für Anaesthesiologie und Operative Intensivmedizin, Klinikum der Justus-Liebig-Universität Giessen.
Anaesthesist. 1996 Sep;45(9):834-8. doi: 10.1007/s001010050318.
Intraoperative autotransfusion is contraindicated in cancer surgery because of the possible risk of systemic tumor spread. The aim of the present study was to investigate whether a cell saver in combination with a white blood cell depletion filter can remove osteosarcoma cells.
A defined number of osteosarcoma cells from an established cell line were added to red cell concentrates and Ringer solution. The tumor cell concentration was 1000/ ml in the first five experiments, 7111/ml in test no. 6, 1667/ml in test no. 7 and 167/ml in test no. 8. Following thorough mixing, each unit was processed separately by a cell saver (DIDECO BT 795/P) in its normal operation mode to produce a red cell concentrate. This red cell concentrate was filtered using a leukocyte depletion filter (PALL BPF 4). Samples were taken before and after processing with the autotransfuser and after filtration with the white cell depletion filter. Cytospin specimens from all samples were examined for osteosarcoma cells by three different methods (Papanicolaou stain, Vimentin antibodies, DNA analysis).
After processing with the autotransfuser, tumor cells were identified in the red cell concentrate. No osteosarcoma cells were evident after the combined use of cell saver and leukocyte depletion filter.
The sole use of the autotransfuser DIDECO BT 795/P during osteosarcoma surgery is not recommended because of the potential danger of retransfusion of malignant cells. In combination with the leukocyte depletion filter PALL BPF 4, no osteosarcoma cells were identified in the red cell concentrate. Since the adhesiveness of tumor cells from established cell lines may be different from that of tumor cells in the intraoperative salvaged blood, further studies with blood from the surgical field are necessary to determine the efficacy of white cell depletion filters to eliminate osteosarcoma cells.
由于存在全身肿瘤播散的潜在风险，术中自体输血在癌症手术中是禁忌的。本研究的目的是探讨细胞回收机联合白细胞滤除器能否清除骨肉瘤细胞。
将来自既定细胞系的一定数量的骨肉瘤细胞添加到红细胞浓缩液和林格氏液中。在前五个实验中肿瘤细胞浓度为1000个/毫升，在实验6中为7111个/毫升，在实验7中为1667个/毫升，在实验8中为167个/毫升。充分混合后，每个单位分别用细胞回收机（DIDECO BT 795/P）以其正常操作模式处理以制备红细胞浓缩液。该红细胞浓缩液用白细胞滤除器（PALL BPF 4）过滤。在用自体输血器处理之前和之后以及用白细胞滤除器过滤之后采集样本。通过三种不同方法（巴氏染色、波形蛋白抗体、DNA分析）检查所有样本的细胞离心涂片标本中的骨肉瘤细胞。
在用自体输血器处理后，在红细胞浓缩液中鉴定出肿瘤细胞。在联合使用细胞回收机和白细胞滤除器后未发现明显的骨肉瘤细胞。
由于存在恶性细胞再输注的潜在危险，不建议在骨肉瘤手术中单独使用自体输血器DIDECO BT 795/P。与白细胞滤除器PALL BPF 4联合使用时，在红细胞浓缩液中未鉴定出骨肉瘤细胞。由于来自既定细胞系的肿瘤细胞的黏附性可能与术中回收血液中的肿瘤细胞不同，因此有必要对手术野的血液进行进一步研究，以确定白细胞滤除器清除骨肉瘤细胞的效果。
