Disseminated tumour cells - Their detection and significance for prognosisof gastrointestinal and pancreatic carcinomas

Metastatic spread is a major factor in the prognosis of cancer patients. Ea rly detection and eradication of circulating tumour cells prior to the deve lopment of metastases could help to improve the outcome of patients after t umour resection. Disseminated tumour cells have been detected in different compartments of the body using cytological and immunostaining methods and, more recently, using different molecular biological techniques. The most fr equently studied body compartments are the bone marrow, peritoneal cavity, blood and lymph nodes, but other body fluids such as urine, bile, pancreati c juice and sputum have also been analysed. At all of these sites, tumour c ells have been detected. However, the specificity and sensitivity of the me thods and their prognostic impact are still being debated. This review disc usses the accuracy of the detection methods and the prognostic value of det ecting disseminated tumour cells in the bone marrow, blood and peritoneal l avage of patients with colorectal, gastric and pancreatic carcinomas.