title: Clinical relevance of circulating tumour cells in the bone marrow of patients with SCCHN.
abstract: BACKGROUND
  Clinical outcome of patients with head and neck squamous cell carcinoma (SCCHN) depends on several risk factors like the presence of locoregional lymph node or distant metastases, stage, localisation and histologic differentiation of the tumour. Circulating tumour cells in the bone marrow indicate a poor prognosis for patients with various kinds of malignoma. The present study examines the clinical relevance of occult tumour cells in patients suffering from SCCHN.
  
  
  METHODS
  Bone marrow aspirates of 176 patients suffering from SCCHN were obtained prior to surgery and stained for the presence of disseminated tumour cells. Antibodies for cytokeratin 19 were used for immunohistochemical detection with APAAP on cytospin slides. Within a clinical follow-up protocol over a period of 60 months, the prognostic relevance of several clinicopathological parameters and occult tumour cells was evaluated.
  
  
  RESULTS
  Single CK19-expressing tumour cells could be detected in the bone marrow of 30.7% of the patients. There is a significant correlation between occult tumour cells in the bone marrow and relapse. Uni- and multivariate analysis of all clinical data showed the metastases in the locoregional lymph system and detection of disseminated tumour cells in the bone marrow to be statistically highly significant for clinical prognosis.
  
  
  CONCLUSIONS
  The detection of minimal residual disease underlines the understanding of SCCHN as a systemic disease. Further examination of such cells will lead to a better understanding of the tumour biology, as well as to improvement of diagnostic and therapeutic strategies.
authors.affiliation: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Schleswig Holstein, Campus Lübeck, Germany. Barbara.Wollenberg@hno.uni-luebeck.de
authors.forename: B
authors.initials: B
authors.lastname: Wollenberg
authors.forename: A
authors.initials: A
authors.lastname: Walz
authors.forename: K
authors.initials: K
authors.lastname: Kolbow
authors.forename: C
authors.initials: C
authors.lastname: Pauli
authors.forename: S
authors.initials: S
authors.lastname: Chaubal
authors.forename: M
authors.initials: M
authors.lastname: Andratschke
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000032:analysis; D008207:Lymphatic Metastasis / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology*; D011379:Prognosis; D013223:Statistics as Topic
chemical_list: D014408:Biomarkers, Tumor; D007633:Keratins