[Simultaneous immunocytochemical detection of tumor cells in lymph nodes and in bone marrow of patients with resectable bronchial carcinomas].
Despite an apparently curative resection more than 50% of patients with non-small cell carcinomas (NSCLC) will relapse after surgery. Therefore, it has to be assumed that in a substantial number of patients a tumor cell dissemination has occurred already at the time of surgery. In a prospective study we analyzed the extend of an early regional tumor cell dissemination into lymph nodes and/or a systemic tumor cell dissemination into the bone marrow in 91 patients with completely resected NSCLC by using sensitive immunocytochemical techniques. A tumor cell dissemination limited to the regional lymph nodes was detected in 14 (15.4%) patients. A systemic dissemination of tumor cells into the bone marrow alone in 10 (11.1%) patients. In 6 patients (6.6%) both body compartments were involved by immunocytochemistry. The detection of a nodal and a systemic tumor cell dissemination was associated with a significantly shortened disease free survival (p = 0.002 and p = 0.05, respectively). A Cox regression analysis demonstrated that the detection of tumor cells by immunocytochemistry is an independent prognostic factor (p = 0.018). In conclusion the detection of disseminated tumor cells by immunocytochemistry is an useful prognostic parameter, which underlines the requirement of a multimodal therapeutic strategy in these patients.
D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000473:pathology / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D018714:Radiotherapy, Adjuvant