Clinical significance of cytokeratin positive cells in bone marrow of gastric cancer patients

Abstract

Bone marrow (BM) is a prognostically relevant indicator organ of micrometastasis; however, the clinical importance of BM micrometastasis in gastric cancer patients is not yet known. In the present study, the BM of 267 consecutive patients with primary gastric cancer was examined for tumor cells using immunocytochemical techniques. Real-time quantitative RT-PCR was used to ensure that the tumor cells were detected properly. Among the 267 cases analyzed, 30 cases (11.2%) had cytokeratin-positive cells in the bone marrow. Positive findings were related to the tumor stage (P<0.05) and to the prominent depth of invasion (P<0.05). All patients with liver metastasis at operation had cytokeratin-positive cells in the BM. Recurrence of the disease was confirmed in 50 cases (18.7%); 4 of 30 (13.3%) in the cytokeratin-positive group and 46 of 237 (19.4%) in the cytokeratin-negative group. There were no significant differences in the 5-year survival rates between the cytokeratin-positive and cytokeratin-negative groups. Our study shows that BM micrometastasis increases according to tumor progression; however, only a subset of cancer cells may survive in the BM and finally evolve to a clinically apparent disease. Therefore it does not accurately predict the prognosis or recurrence of the disease.

Disseminated Tumor Cells in Bone Marrow of Gastric Cancer Patients: Correlation with Tumor Hypoxia and Clinical Relevance

“…Nevertheless, authors proposed to continue these studies, in particular in multicenter protocol investigations. At the same time some observations have been published where the clinical relevance of DTCs in gastric cancer patients was not observed [19–21]. Recently published review of Bidard et al [22] allows to conclude that problem of DTCs in gastric cancer is relevant for clinics but it is not fully solved and needs to be clarified to improve the treatment outcome.…”

miR-615-3p expression level in bone marrow is associated with tumor recurrence in hepatocellular carcinoma

“…Over the past 20 years, evidence has been accumulating that the presence of DTCs in bone marrow (BM) is a prognostic indicator for patients with various types of cancer. However, recent studies indicate that all the patients with DTCs do not necessarily develop recurrence and/or metastasis (6,7). In a recent study we demonstrated that DTCs are observed in BM even in patients with early-stage gastric cancer (8).…”

Disseminated and circulating tumor cells in gastrointestinal oncology

“…Bone marrow DTCs have been reported by several detection techniques in surgically resected gastric cancers: CK18 [33]; CK2-immunostaining [34]; anti-human epithelial antigen (Ber-EP4) [35]; CK20 RT-PCR [36], CK20/CK19/CEA RT-PCR [37], CK7/CK8 RT-PCR [38], CEA/CK20/TFF1/MUC2 RT-PCR [39]. About half of these studies reported a significant negative prognostic impact on metastases-free and/or overall survival.…”