Spectrum of cytokeratin-positive cells in the bone marrows of colorectal carcinoma patients.
BACKGROUND
Bone marrow micrometastases (BMM) is considered to be of interest as a prognostic marker in solid tumors. The use of density-gradient separated bone marrow (BM) aspirates does not allow proper morphological characterization of the cells. An alternative approach, using routinely processed clots of BM aspirates, is presented.


METHODS
BM clots from 56 colorectal carcinoma patients were stained for cytokeratin (CK), p53 and Ki67 by double immunohistochemistry. Cytokeratin-positive (CK+) cells were immunohistochemically divided into three groups, viz. Group A (CK+ probably malignant epithelial cells), Group B (CK+ morphologically non-epithelial cells) and Group C (CK+ contaminating cells).


RESULTS
Thirty-three patients (59%) had CK+ cells, of which 19 (58%) had Group A cells and 14 (42%) had Group B cells. Fourteen of the 56 patients had reactive BM, eight of these had Group A cells and 3 had Group B cells. Group B cells and Group C cells did not express p53. Group A cells were noted in 35% of patients with carcinomas of Dukes' stage C and in 41% of patients with metastatic disease.


CONCLUSIONS
Double immunohistochemical staining of routinely processed BM clot, for p53 and Ki67 along with CK allows the sub-classification of CK+ cells.
Department of Oncology/Pathology (Radiumhemmet), Karolinska, University Hospital Solna, SE-171 76 Stockholm, Sweden. jayant.shetye@cck.ki.se
Jayant D
JD
Shetye
Maria L
ML
Liljefors
Stefan O
SO
Emdin
Jan-Erik
JE
Frödin
Karin
K
Strigård
Håkan T
HT
Mellstedt
Anja
A
Porwit
D001707:Biopsy, Needle / Q000379:methods; D019046:Bone Marrow Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000556:secondary*; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis*; D019394:Ki-67 Antigen / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D007633:Keratins