title: Micrometastasis in non-small-cell lung cancer: Detection and staging.
abstract: BACKGROUND
  The clinical relevance of bone marrow micrometastasis (BMM) in non-small-cell lung cancer is undetermined, and the value of such analyses in advanced stage patients has not been clearly assessed previously. This study was conducted to estimate the accuracy of both polymerase chain reaction (PCR) and immunohistochemistry (IHC) in micrometastases detection and determine the best site for bone marrow biopsy in order to find micrometastasis.
  
  
  METHODS
  This prospective cross-sectional study was performed in the Department of Thoracic Surgery, Alzahra University Hospital from September 2008 to June 2009. To evaluate the bone marrow, a 3-cm rib segment and an aspirated specimen from the iliac bone prior to tumor resection were taken. PCR and IHC were performed for each specimen to find micrometastasis.
  
  
  RESULTS
  Of 41 patients, 14 (34%) were positive for BMM by PCR compared with two positive IHC (4.8%). All BMMs were diagnosed in rib segments, and iliac specimens were all free from metastatic lesion. Our data showed no significant association between variables such as age, sex, histology, tumor location, side of tumor, involved lobe, smoking, or weight loss and presence of BMM.
  
  
  CONCLUSIONS
  PCR could use as a promising method for BMM detection. BMM in a sanctuary site (rib) is not associated with advanced stages of lung cancer. In addition, when predictor variables such as age, sex, histology, tumor location, smoking, or weight loss are analyzed, no correlation can be found between micrometastasis prevalence and any of those variables.
authors.affiliation: Department of Thoracic Surgery, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Mohajeri
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Sanei
authors.forename: Sayyed Abbas
authors.initials: SA
authors.lastname: Tabatabaee
authors.forename: Sayyed Mozaffar
authors.initials: SM
authors.lastname: Hashemi
authors.forename: Elham
authors.initials: E
authors.lastname: Amjad
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Mohajeri
authors.forename: Hamid
authors.initials: H
authors.lastname: Shemshaki
authors.forename: Amir Hosein Davarpanah
authors.initials: AH
authors.lastname: Jazi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Kolahdouzan