Bone marrow micrometastases in patients with stage I-II localised prostatecancer

Prostate cancer commonly metastasises to the bones. Detection of bone marro w micrometastases (BMM) may give important information that helps define tr eatment strategies. This study was undertaken to analyse BMM in early prost ate cancer patients and to determine the accuracy of immunohistochemical (I HC) and morphological methods in detecting cancerous cells. Preoperative co re bone marrow biopsy (BMB) was performed in 103 patients with T1-2, N0, MO prostate cancer after neoadjuvant androgen blockade. BMB were examined by IHC using monoclonal antibodies for cytokeratins (CK) (18, 19, PAN) and by cytomorphology of IHC-positive cells. In 103 patients, BMM were detected in 2 cases (2%) and an additional 3 cases (3%) were classified as suspicious. IHC alone revealed positive cells in 19 patients (18%). Cytomorphology dis closed IHC false-positive staining of some apparently normal bone marrow el ements such as plasmocytes. The study shows a rather low rate of BMM in ear ly prostate cancer. It also stresses the importance of cytomorphology as an adjunct to IHC as IHC alone may not be sufficient and appropriate for BMM detection. (C) 2001 Published by Elsevier Science Ltd.