IMMUNOCYTOLOGICAL DETECTION OF MICROMETASTATIC CELLS - COMPARATIVE-EVALUATION OF FINDINGS IN THE PERITONEAL-CAVITY AND THE BONE-MARROW OF GASTRIC, COLORECTAL AND PANCREATIC-CANCER PATIENTS

The prognosis of digestive cancers is poor mainly due to intraperitone al relapse by cells which may have already been seeded at the time of surgery. Using immunocytology we investigated the peritoneal cavity an d, as a comparison, the bone marrow of 147 patients with gastric, colo rectal and pancreatic cancer for micrometastatic cells. Cytological sa mples from peritoneal cavity lavages and bone marrow aspirates were an alyzed using monoclonal antibodies (Mabs) against tumor-associated ant igens (TAA) (CEA CA-19-9, 17-1-A, C-54-0, Ra96) and compared to a MAb staining cytokeratins (KL-1). Patients with benign diseases served as controls. Intraperitoneal micrometastatic cells were detected in 27% o f colorectal, 43% of gastric and 58% of pancreatic cancer patients. In the bone marrow, the corresponding data were 29% for colorectal, 25% for gastric and 58% for pancreatic cancer patients. Combined evaluatio n of both compartments increased the detection rate significantly (col orectal cancer: 40%, gastric cancer: 52%, pancreatic cancer: 72%). No unwarranted reactions were found in the control group. Combining 3 per itoneal cavity samples. In the bone marrow, the use of 2 antibodies (K L-1 and CA-19-9) detected 94% of all positive samples, where KL-1 and CA-19-9 strained approx. 70% of all positive samples in each case. The occurence of stained cells in the peritoneal cavity correlated with c lassical prognostic factors (TNM classification). (C) 1994 Wiley-Liss, Inc.