Correlation of bone marrow micrometastases (BMM) with nodal status in gastrointestinal tumors (GI)

Autor: Sukamal Saha, Alpesh Korant, Madhumitha Krishnamoorthy, Mohammed Nawaf Kanaan, Benjamin Abadeer, Madan L. Arora, T. Trevor Singh, Sunil Nagpal, David Wiese
Rok vydání: 2013
Předmět:
Zdroj: Journal of Clinical Oncology. 31:567-567
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2013.31.4_suppl.567
Popis: 567 Background: Presence of BMM is an important prognostic factor for patients (pts) with solid tumors. Sentinel lymph node (SLN) mapping (M) has been found to upstage pts with GI tumors. However, a direct correlation between the presence of BMM and nodal metastases is lacking. Hence, a retrospective study was undertaken to determine the relationship between BMM and nodal status in GI tumors. Methods: A total of 385 consecutive pts with GI tumors were analyzed. All pts underwent bilateral posterior superior iliac spine BM aspiration. This protocol employs highly sensitive staining methods combined with automated microscopy to differentiate cytokeratin +ve cells of epithelial origin from normal hematopoetic cells in BM. The cytospin slides were stained with the monoclonal anti-CAM 5.2 antibody from Becton Dickinson at a 1:25 dilution. Visualization was achieved with Ventana view Red detection system. The slides were counterstained with Ventana haematoxylin. The Automated Cellular Imaging System is applied to detect, count, and classify cells of clinical interest based upon the recognition of cellular objects of particular color, size and shape. SLNM when applicable was done by peritumoral injection of 1% methylene blue. Results: Of these 385 pts, 11.2% were found to have BMM. When analyzed by sites, the 3 highest BMM were Cholangiocarcinoma 33%, Stomach 22% and esophagus 13%. The BMM was +ve bilaterally in 44%; unilaterally in 56%. In pts who underwent SLNM, BMM were found in 8.3% of SLN +ve vs. 12% for SLN -ve pts. For pts with colon cancer undergoing SLNM, BMM were found in 9.6% of SLN +ve pts vs. 11.1% for SLN -ve pts. Conclusions: BMM did not correlate with nodal status for GI malignancies suggesting a possible different mechanism for metastases. Detection of BMM may have a significant clinical value in SLN negative pts who may benefit from adjuvant therapy. [Table: see text]
Databáze: OpenAIRE
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