Meta-analyses of studies on bone marrow micrometastases: an independent prognostic impact remains to be substantiated.

Funke, I.; Schraut, W.

doi:10.1200/jco.1998.16.2.557

Cited by 207 publications

(110 citation statements)

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“…3 Epithelial cells in bone marrow have been detected in various carcinoma types. 4 In a few studies the presence of these cells independently correlated with poor outcome, 5,6 although their prognostic impact was controversial 7,8 and remains to be substantiated. Discussed as an early indicator for the generalization of the tumor disease, epithelial cells detected in bone marrow were introduced as a facultative prognostic factor in the TNM classification, 9 referred as isolated tumor cells.…”

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confidence: 99%

MHC class I negative phenotype of disseminated tumor cells in bone marrow is associated with poor survival in R0M0 breast cancer patients

2001

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MHC class I negative phenotype of disseminated tumor cells in bone marrow is associated with poor survival in R0M0 breast cancer patients

2001

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“…Bone marrow isolated tumour cells are also evident in many patients with gastric cancer, but its prognostic significance is still uncertain (Funke and Schraut, 1998;Hermanek et al, 1999). This study was aimed at quantifying the presence of bone marrow involvement and its possible prognostic value in curatively resected gastric cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude of 10 6 mononuclear cells has been shown to provide a higher probability of detecting even one or two positive cells (Borgen et al, 1998;Funke and Schraut, 1998). Another aspect that might be a source of pitfalls is that during the cytospin procedure there is a loss of mononuclear cells and the number of cells rescued on the slides is lower than that counted in the suspension before starting the procedure.…”

Section: Ck-ck+mentioning

confidence: 99%

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The presence of bone marrow cytokeratin-immunoreactive cells does not predict outcome in gastric cancer patients

et al. 2002

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The independent prognostic significance of isolated tumour cells in bone marrow is still a matter of debate. This study evaluated the possible association of bone marrow micrometastases with tumour progression and prognosis in patients affected by gastric cancer. Bone marrow aspirates from both iliac crests were obtained from 114 consecutive patients operated on for gastric cancer. The specimens were stained with monoclonal antibody CAM 5.2 which reacts predominantly with cytokeratin filaments 8 and 19. Among 114 cases analysed, 33 cases (29%) had cytokeratine-positive cells in the bone marrow. There was no significant relationship between the presence of bone marrow micrometastases and site, depth of tumour invasion, lymph node metastases, presence of metastases. Patients with cytokeratine-positive cells had a trend towards a diffuse type histology (P=0.06). Among the 88 curatively resected patients, median survivals were 40 months and 36 months for cytokeratine-negative and cytokeratine-positive subsets respectively (P=0.9). Recurrence of the disease was observed in 39 cases (44.3%); 11 of 24 (45.8%) in the cytokeratine-positive subset and 28 of 64 (43.7%) in the cytokeratine-negative subset. In conclusion in our experience the presence of cytokeratine-positive cells in the bone marrow of curatively resected gastric cancer patients did not affect outcome and its independent prognostic significance remains to be proven before its official acceptance in the TNM classification.

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“…It cannot be detected by any routine biochemical and histopathological assays or any graphical methods such as X-ray, CT, MRI, etc. [7][8][9][10][11] . At the same time, the patients have not any obvious symptoms.…”

Section: Introductionmentioning

confidence: 99%

Detection of micrometastasis of gastric carcinoma in peripheral blood circulation

Chen¹,

Chen²,

Wang³

et al. 2004

WJG

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AIM:To detect the micrometastasis of gastric carcinoma in peripheral blood circulation using immunomagnetic beads sorting technique and RT-PCR technique, and to discuss its significance and the difference between the two methods. METHODS:Density gradient centrifugation was used to isolate mononuclear cells from peripheral blood, immunomagnetic beads sorting technique and RT-PCR technique were used to detect the disseminated carcinoma cells. HE, immunocytochemical and immunofluorescence staining were also used to identify the characteristics of the cells separated with immunomagnetic beads sorting technique. RESULTS:Cells expressing cytokeratin were separated and enriched from the peripheral blood specimens of patients suffering from gastric carcinoma or chronic gastritis. After HE staining, two kinds of cells with little cytoplasm were found. Majority of these cells had small and round nuclei, even chromatins and the thickness of nuclear membrane was normal. Immunohistochemical staining indicated that there were CD34 and CD45 expression on the cell membrane of this kind of cells and these cells also showed expressed human telomerase reverse transcriptase by immunofluorescence staining, but the expression of carcinoembryonic antigen was absent. So, these cells might hematopoiesis precursors. Another kind of cells had larger and abnormal nuclei with thicker nuclear membranes. Massed chromatins and polynucleoli were found in the nuclei. These cells expressed human telomerase reverse transcriptase and carcinoembryonic antigen, but CD34 and CD45 were not found on the cell membrane. So, these cells were considered as gastric carcinoma cells escaping from the original focuses and existing in the peripheral blood circulation. Carcinoma cells were found in 25 of 60(41.7%) specimens of peripheral blood from patients with gastric carcinoma, while there were no such cells separated from the blood specimens of chronic gastritis patients. The difference of positive rates of disseminated carcinoma cells between two groups was markedly significant (P<0.005). The expressions of CK20 mRNA in peripheral blood specimens were examinated with RT-PCR. CK20 mRNA was detected from 32 of 60(53.3%) peripheral blood specimens in the group of gastric carcinoma patients, while none of the specimens from patients suffering from chronic gastritis had CK20 mRNA. Significant difference was also found between two groups (P<0.005). Statistic analyses also showed that there was a significant difference between the positive rates of two methods in detecting the disseminated carcinoma cells from the peripheral blood circulation of gastric carcinoma patients (P<0.05). CONCLUSION:The results demonstrated that there were disseminated carcinoma cells in the peripheral blood circulation of some patients with gastric carcinoma. Disseminated carcinoma cells can be detected from the peripheral blood samples with immunomagnetic beads sorting technique and RT-PCR technique. The positive rate of RT-PCR technique is higher than that of immunomagnetic be...

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Meta-analyses of studies on bone marrow micrometastases: an independent prognostic impact remains to be substantiated.

Abstract: In conclusion, the results suggest that the prognostic impact of epithelial cells in bone marrow remains to be substantiated by further studies using standardized methodic protocols before its entrance in the TNM classification.

Cited by 207 publications

References 0 publications

MHC class I negative phenotype of disseminated tumor cells in bone marrow is associated with poor survival in R0M0 breast cancer patients

MHC class I negative phenotype of disseminated tumor cells in bone marrow is associated with poor survival in R0M0 breast cancer patients

The presence of bone marrow cytokeratin-immunoreactive cells does not predict outcome in gastric cancer patients

Detection of micrometastasis of gastric carcinoma in peripheral blood circulation

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