Molino A, Pelosi G, Turazza M, Sperotto L, Bonetti A, Nortilli R, Fattovich G, Alaimo C, Piubello Q, Pavanel F, Micciolo R, Cetto G L
Department of Medical Oncology, University of Verona, Italy.
Breast Cancer Res Treat. 1997 Jan;42(1):23-30. doi: 10.1023/a:1005747711084.
The presence in bone marrow of cells which react with monoclonal antibodies against tumor-associated antigens has been proposed over the last few years as a new prognostic factor in breast cancer patients.
Bone marrow aspirates were obtained from 109 stage I and II breast cancer patients during or 2-4 weeks after primary surgery. The samples were processed for leukocyte separation on a Ficoll-Hypaque gradient and then used to prepare cytospin slides for immunocytochemical analysis. The slides were stained with a pool of monoclonal antibodies (MoAbs) which recognize tumor associated antigens, using the alkaline phosphatase anti-alkaline phosphatase method. The median follow-up was 36 months (range 15-62): 22 patients relapsed and 7 died.
Thirty-four of the 109 patients (31.1%) had MoAb positive bone marrow cells. The bone marrow was positive in 28/74 (37.9%) patients who had the aspirate taken during surgery and in 6/35 (17.1%) who had it taken after surgery (p = 0.055). No association was found between bone marrow positivity and tumour size, nodal status, menopausal status, estrogen receptor positivity or the proliferative index. No association was found between bone marrow and prognosis: the log-rank test was 0.291 (p > 0.5) for OS and 0.023 for DFS; the hazard ratio (positive vs negative) was 1.51 for OS (95% CI: 0.33-6.86) and 0.93 for DFS (95% CI: 0.35-2.45).
In our series, bone marrow positivity did not correlate with prognostic parameters or prognosis. Of interest is the relative excess of positivity when the bone marrow was obtained during surgery.
在过去几年中，有人提出骨髓中存在与抗肿瘤相关抗原的单克隆抗体发生反应的细胞，可作为乳腺癌患者的一种新的预后因素。
在109例Ⅰ期和Ⅱ期乳腺癌患者初次手术期间或术后2 - 4周采集骨髓抽吸物。样本在Ficoll - Hypaque梯度上进行白细胞分离处理，然后用于制备细胞离心涂片进行免疫细胞化学分析。采用碱性磷酸酶抗碱性磷酸酶法，用一组识别肿瘤相关抗原的单克隆抗体（MoAbs）对涂片进行染色。中位随访时间为36个月（范围15 - 62个月）：22例患者复发，7例死亡。
109例患者中有34例（31.1%）骨髓细胞MoAb阳性。手术期间采集抽吸物的74例患者中有28例（37.9%）骨髓呈阳性，术后采集抽吸物的35例患者中有6例（17.1%）骨髓呈阳性（p = 0.055）。未发现骨髓阳性与肿瘤大小、淋巴结状态、绝经状态、雌激素受体阳性或增殖指数之间存在关联。未发现骨髓与预后之间存在关联：总生存期（OS）的对数秩检验为0.291（p > 0.5），无病生存期（DFS）的对数秩检验为0.023；总生存期的风险比（阳性与阴性）为1.51（95%可信区间：0.33 - 6.86），无病生存期的风险比为0.93（95%可信区间：0.35 - 2.45）。
在我们的研究系列中，骨髓阳性与预后参数或预后无关。值得关注的是手术期间采集骨髓时阳性率相对较高。
