Original Paper

Immunocytochemical Detection of Occult Tumor Cells in the Bone Marrow: Prognostic Impact on Early Stages of Lung Cancer
M. Nosotti, D. Tosi, A. Palleschi, L. Rosso, P. Mendogni, L. Santambrogio

Thoracic Surgery Unit, Fondazione Ospedale Policlinico, Mangiagalli e Regina Elena, Milan, Italy

Address of Corresponding Author

Eur Surg Res 2008;41:267-271 (DOI: 10.1159/000141961)

  Key Words

• Micrometastases
• Bone marrow
• Lung cancer

  Abstract

Objectives: This study was designed to verify the prognostic impact of occult tumor cells in the bone marrow of stage I and II non-small-cell lung cancer patients using cytokeratin as a micrometastatic marker. Methods: One hundred and fifty-two patients with stage I and II non-small-cell lung cancer, who underwent radical surgery by pulmonary lobectomy, were entered into the study. Bone marrow from fragments of resected ribs, and primary tumors were stained by anti-cytokeratin 18 antibody. Fourteen bone marrow specimens from patients without malignancy were used as a control group. Cancer recurrence was the study end point. Results: All the primary tumors were positive for cytokeratin; occult tumor cells were detected in 38 bone marrow specimens (25%). The prevalence of the occult tumor cells was not related to age, gender, tumor stage, histological differentiation or grade. The mean follow-up time was 35.3 months; 68 patients developed recurrence; the mean time for recurrence was 21.2 months. The general disease-free interval was not related to the presence of occult tumor cells in the bone marrow. This result did not change when grouping the patients by tumor stage. The stage was the best predictor of cancer recurrence (Cox proportional hazards model ratio: 2.09; p = 0.0026). Conclusions: This study confirms that immunocytochemical analysis detects occult tumor cells in the bone marrow of at least 25% of patients surgically treated for stage I and II non-small-cell lung cancer. These occult tumor cells do not have any impact on the disease-free interval.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Davide Tosi
p.za Wagner, 4
IT–20145 Milano (Italy)
Tel. +39 02 5503 5513, Fax 39 02 5503 5848, E-Mail dadonga@libero.it

  Article Information

Received: November 27, 2007
Accepted after revision: February 5, 2008
Published online: July 1, 2008
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 25