Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Cytokeratin-positive Cells in the Bone Marrow of Patients with Gastric Cancer

위암 환자의 골수에서 발견된 Cytokeratin 양성세포의 임상적 의의

  • Shin, Jung-Hye (Departments of Surgery Kyungpook National University Hospital) ;
  • Ku, Ki-Beom (Departments of Surgery Kyungpook National University Hospital) ;
  • Park, Seong-Hoon (Departments of Surgery Kyungpook National University Hospital) ;
  • Chung, Ho-Young (Departments of Surgery Kyungpook National University Hospital) ;
  • Bae, Han-Ik (Departments of Pathology, Kyungpook National University Hospital) ;
  • Yu, Wan-Sik (Departments of Surgery Kyungpook National University Hospital)
  • Published : 2006.12.30
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Abstract

Purpose: Controversy still exists over in the prognostic significance of microscopic tumor cell dissemination in patients with cancer. This study evaluated the prognostic implication of isolated tumor cells in the bone marrow of patients with gastric cancer. Materials and Methods: Four hundred nineteen (419) patients who underwent surgery for gastric cancer between June 1998 and July 2000 were enrolled in the study. Bone marrow aspirate was obtained from the iliac crest before removal of the primary tumor. Mononuclear cells were isolated and stained with AE-1/AE-3 PAN-CYTOKERATIN. Results: Cytokeratin-positive cells were found in the bone marrow of 219 patients (52.3%). The incidence varied significantly with the depth of invasion (P=0.021) and the stage (P=0.026). The five-year survival rate of patients with cytokeratin-positive cells was 74.1% and that of patients without cytokeratin-positive cells was 81.1%(P=0.2481). There were no significant differences in the recurrence rate and the site of recurrence according to whether or not cytokeratin-positive cells were present in the bone marrow. Conclusion: The presence of cytokeratin-positive cells in the bone marrow of patients with gastric cancer did not predict outcome and recurrence. Therefore, it cannot be used as a prognostic factor.

목적: 암 환자의 골수에서 발견되는 cytokeratin 양성세포와 암의 재발과의 상관관계에 대해서는 알려진 바가 많지 않다. 이에 위암환자의 골수에서 발견되는 cytokeratin 양성세포가 위암 환자의 재발과 생존율을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법: 1998년 6월부터 2000년 7월까지 경북대학교병원 외과에서 원발성 위암으로 수술받은 환자 419명을 대상으로 하였다. 수술 직전 장골능선에서 골수를 흡인하여 단핵구를 분리하고 항 cytokeratin 항체를 이용하여 면역세포화학적 염색을 하였다. 결과: Cytokeratin 양성세포는 219예(52.4%)에서 발견되었고, 위암의 침윤깊이(P=0.021), 병기(P=0.026)에 따라서 통계학적으로 유의한 차이가 있었으나, 암의 위치, 육안형, 림프절전이, 원격전이, 분화도에 따라서는 유의한 차이가 없었다. 골수의 cytokeratin 양성세포 유무에 따른 5년 생존율은 유의한 차이가 없었고(P=0.248), 재발여부, 재발부위도 유의한 차이가 없었다. 결론: 위암 환자의 골수에서 cytokeratin 양성세포 유무는 예후인자로 사용되기 어렵고 재발양상을 예측하기도 어렵다.

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