IMMUNOCYTOLOGICAL STAINING OF BONE-MARROW IN PATIENTS WITH CLINICALLYORGAN-CONFINED TUMORS - DETECTION OF EARLY TUMOR DISSEMINATION

In many cases early tumor dissemination determines the prognosis of ma lignant diseases. We present our results achieved using a procedure wh ereby a micrometastic spread of urological tumors in bone marrow can b e proved using monoclonal antibodies to cytokeratin 18 (CK 18). Cytoke ratins are characteristic of epithelial cells and are suitable for the ir identification in cell preparations. Cells of an epithelial origin are not normally found in mesenchymal organs such as bone marrow. The presence of these cells is therefore a sign of dissemination of epithe lial tumors. Overall 43 of 104 patients with clinically organ-confined tumors had CK 18-positive cells in bone marrow aspirations, Patients with transitional cell carcinoma and renal cell carcinoma showed a str ong correlation between the presence of CK 18-positive cells and the p TNM-stage, which was not found in patients with prostata cancer. In fu ture follow ups the therapeutic and prognostic relevance of these obse rvations must be evaluated further.