Lung CancerMicrometastasis in the bone marrow of patients with lung cancer associated with a reduced expression of E-cadherin and β-catenin: Risk assessment by immunohistochemistry☆,☆☆
Section snippets
Patients
From May 1996 to November 1997, 58 patients with NSCLC underwent complete resection by a lobectomy combined with formal mediastinal and hilar lymph node dissection. Of these patients, 44 had adenocarcinomas, 13 had squamous cell carcinomas, and 1 had adenosquamous cell carcinoma. They consisted of 33 men and 25 women ranging in age from 26 to 85 (mean, 68.3).
Evaluations regarding the presence of distant metastasis were based on CT scans (brain, chest, and abdomen) and bone scintiscan. None of
Detection of CK-positive cells in bone marrow
CK-positive cells were detected ranging from 1 to 18 cells of 1 × 106 cells examined in the bone marrow aspirates from 27 of 58 patients (47%) with NSCLC. Table I summarizes the relationship between the presence of CK-positive cells in bone marrow and various clinical factors.
Variable No. of patients No. of patients with CK-positive cells P value Gender Male 33 16 .7345 Female 25 11 Tumor status T1, T2 47 19
Discussion
To identify circulating cancer cells, an immunohistochemical assay4, 5, 6, 10, 11, 12, 13, 14, 15 and molecular approaches such as the sensitive reverse-transcriptase polymerase reaction technique16, 17, 18 have been developed. An immunohistochemical assay based on monoclonal antibodies to CKs is a well-established method for detecting epithelial cells disseminated to the bone marrow. Pantel et al5 reported that the specificity of CK-expression was supported by an overall negative finding on
Acknowledgements
We thank Mr Brian Quinn for his comments on the linguistics of the manuscript.
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Supported by a Grant-in-Aid from the Ministry of Education, Science, Sports, and Culture, Japan.
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Reprint requests: Kenji Sugio, MD, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.