EPITHELIAL TUMOR-CELLS IN BONE-MARROW OF PATIENTS WITH PANCREATIC-CARCINOMA DETECTED BY IMMUNOCYTOCHEMICAL STAINING

In the present study, epithelial cells in the bone marrow of 42 patien ts with pancreatic carcinoma were identified immunocytochemically with monoclonal antibodies (MAbs) CK2, KL1 and A45-B/B3 directed to epithe lial cytokeratins (CK), using the alkaline phosphatase anti-alkaline p hosphatase method. The specificity of the MAbs was demonstrated by neg ative staining of marrow from 25 non-carcinoma age-matched control pat ients. Analysis of bone marrow aspirates from cancer patients revealed CK-positive cells in 14 (58.3%) of 24 cancer patients treated with cu rative intent and 10 (55.6%) of 18 patients with extended disease. Aft er a median follow-up of 15.6 months (range 3-31 months), 5 (35.7%) ou t of 14 patients who underwent complete surgical resection but had tum our cells in bone marrow presented with distant metastasis and 6 (42.9 %) with local relapse as compared to none of 10 corresponding patients without such cells (P < 0.05). The described technique may help to id entify patients with pancreatic cancer and potential high risk of earl y metastatic relapse. The results promise to be of important assistanc e in determining prognosis and consequences in therapy of early stage pancreatic cancer.