Clinical significance of bone marrow micrometastases in esophageal cancer.
Using the reverse transcriptase-polymerase chain reaction (RT-PCR), we investigated the clinical significance of bone marrow micrometastases in patients with esophageal cancer. Bone marrow samples from 57 patients with esophageal cancer, who underwent esophagotomy, were investigated by specific RT-PCR for carcinoembryonic antigens (CEA). A total of 40 out of 57 patients (70.1%) were positive for CEA mRNA in the bone marrow. Among curatively resected cases, 34 of 50 patients (68.0%) were positive for CEA. Ten of 13 T1 patients (76.9%) were positive for CEA. Although the CEA-positive rate was high, there was no significant correlation between CEA positivity and any clinical characteristics. Among the 40 CEA-positive patients, 50% have shown recurrence so far. Detection of cancer cells in the bone marrow by RT-PCR may not always correspond to the malignant potential or other characteristics of the tumor. CEA-positive 'micrometastases' might actually represent isolated circulating tumor cells without much biological significance.
Inoue
H
H
First Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan. hinoue@wk9.so-net.ne.jp
Kajiyama
Y
Y
Tsurumaru
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000378:metabolism / Q000556:secondary*; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000556:secondary* / Q000601:surgery; D016009:Chi-Square Distribution; D004938:Esophageal Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger