Cohen A M, Garin-Chesa P, Hanson M, Weyhrauch K, Kemeny N, Fong Y, Paty P, Welt S, Old L
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
Dis Colon Rectum. 1998 Sep;41(9):1112-5. doi: 10.1007/BF02239432.
The purpose of this study was to assess the immunocytochemical status of bone marrow aspirates from patients with clinically isolated hepatic metastases to test the hypothesis that such findings would allow improved patient selection for liver-directed treatment.
All patients had biopsy-proven or presumed colorectal cancer metastatic to the liver and were scheduled for an operative procedure for hepatic resection or for hepatic artery catheter and chemotherapy pump implant. Immunocytochemical analysis of bone marrow aspirate smears was performed with a panel of monoclonal antibodies directed toward cytokeratins, Lewis Y antigen and A-33 colorectal epitopes.
Data from 80 patients indicated that bone marrow reactivity was present in 9.5 percent of those with resectable hepatic metastases and in 34 percent of those not resected (P = 0.03). No single monoclonal antibody or combination produced better discrimination.
Presence or absence of presumed occult colorectal cancer cells in the bone marrow of patients with isolated hepatic metastases is biologically interesting, but not useful in selecting or altering patient management.
本研究旨在评估临床孤立性肝转移患者骨髓穿刺物的免疫细胞化学状态，以检验这样的发现能否改善肝靶向治疗患者选择的假说。
所有患者均经活检证实或推测为结直肠癌肝转移，且计划接受肝切除手术或肝动脉导管及化疗泵植入手术。采用一组针对细胞角蛋白、Lewis Y抗原和A-33结直肠表位的单克隆抗体对骨髓穿刺涂片进行免疫细胞化学分析。
80例患者的数据表明，可切除肝转移患者中9.5%存在骨髓反应性，未切除患者中34%存在骨髓反应性（P = 0.03）。没有单一的单克隆抗体或组合能产生更好的鉴别效果。
孤立性肝转移患者骨髓中是否存在推测的隐匿性结直肠癌细胞在生物学上很有趣，但对选择或改变患者治疗并无帮助。
