Cellular composition of stent-penetrating tissue.
BACKGROUND
A surprisingly low number (< 20%) of relevant (> 75%) restenoses occur in exophytic lesions after treatment with uncovered metal stents. The goal of this study was to investigate whether radial stent forces can exert localized influence on tumor growth.


METHODS
In 17 patients, intraluminal tumor tissue was histologically investigated before and 1 week after stent implantation. The amount of intact tumor cells (ITCs) was compared to necrotic and nontumor cells. The result in patency was proved by fiberoptic bronchoscopy.


RESULTS
Initially, stenoses in all patients were > 75%. Before stent implantation, biopsy samples in seven patients showed > 67% ITCs, and five patients had 34 to 67% ITCs. Five patients had 1 to 33% ITCs, and no patients had 0% ITCs. One week after stent implantation, the cellular aspect of the biopsy samples had changed significantly (p < 0.03): two patients had > 67% ITCs, one patient had 34 to 67% ITCs, and seven patients had 1 to 33% ITCs. Seven patients had no ITCs at all. Endoscopically, patency increased significantly (prestent, 10 +/- 14.1%; poststent, 90.6 +/- 14.3% [mean +/- SD]; p < 0.0001).


CONCLUSIONS
Pressure exerted by the stent on adjacent tumor tissue may cause a profound reduction in the amount of ITCs, most probably caused by radial and shear stress forces that compromise blood supply and nutrients of the tumor stroma.
Hauck
Rainer W
RW
Medizinische Klinik II, Städtisches Krankenhaus Bad Reichenhall, Technische Universität, Munich, Germany. hauck@krankenhaus-bad-reichenhall.de
Barbur
Marius
M
Lembeck
Rolf
R
Peltz
Friedhelm
F
Werner
Martin
M
D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000628:therapy; D003251:Constriction, Pathologic; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D015607:Stents