بررسي ميزان درگيري مغزاستخوان دربيماران جراحي شده سرطان مري

Evaluation of Bone Marrow Involvement in Surgically Resected Patients with Esophageal Cancer

Introduction: Bone marrow samples obtained during rib resections in esophageal cancer patients evaluated by immunohistochemical and quantitative polymerase chain reaction techniques revealed disseminated tumor cells in up to 90% samples, but the clinical relevance of these findings is unclear. Objective: Evaluation of bone marrow involvement in these patients and its correlation with clinicopathological finding of tumor. Materials and Methods: 43 patients with esophageal cancer who referred to Omid and Ghaem hospitals from April 2008-2009 were selected to transthorasic surgery(without neoadjuvant treatment).Bone marrow samples from rib were evaluated by Hematoxylin-Eosin staining for tumoral involvement and cytokeratin immunohistochemistry to determine micrometastatic cells. The results were compared with primary tumor histopathologial characteristics; T stage, N stage, tumoral length and personal characteristics; age & sex. Results: Patients mean age was 60.9(51-70 years), the ratio of male to female was 2.9. 38 cases (88.4%) had squamous cell carcinoma and 5(11.6%) adenocarsinoma. In 9 cases (20.9%) Hematoxylin-Eosin staining and 13 cases (30.2%) immunohistochemistry results were positive. There was no correlation between pathologic type and T stage with Hematoxylin-Eosin and cytokeratin results. (p=0.277, p=0.153) and (p=0.221, p=0.097). There was a significant relation between bone marrow dissemination and mediastinal involvement and tumoral grade (p=0.008, p=0.001) and (p=0.002, p=0.001). Conclusion: According to our study, there is a correlation between grade and N stage and bone marrow involvement in esophageal cancer patients and there is no statistically correlation with other clinicopathologial characteristic there is a low bone marrow involvement in our region patients, overally.