文摘
Background: The presence in bone marrow of cellswhich react with monoclonal antibodies against tumor-associated antigenshas been proposed over the last few yearsas a new prognostic factor in breast cancer patients.Patients and methods: Bone marrow aspirates were obtainedfrom 109 stage I and II breast cancerpatients during or 2–4 weeks after primary surgery.The samples were processed for leukocyte separation ona Ficoll-Hypaque gradient and then used to preparecytospin slides for immunocytochemical analysis. The slides werestained with a pool of monoclonal antibodies (MoAbs)which recognize tumor associated antigens, using the alkalinephosphatase anti-alkaline phosphatase method. The median follow-up was36 months (range 15–62); 22 patients relapsed and7 died.Results: Thirty-four of the 109 patients (31.1%) hadMoAb positive bone marrow cells. The bone marrowwas positive in 28/74 (37.9%) patients who hadthe aspirate taken during surgery and in 6/35(17.1%) who had it taken after surgery (p = 0.055).No association was found between bone marrow positivity and tumour size,nodal status, menopausal status, estrogen receptor positivityor the proliferative index. No association was found between bone marrow andprognosis: the log-rank test was 0.291 (p >0.5) for OS and 0.023 for DFS; thehazard ratio (positive vs negative) was 1.51 forOS (95% CI: 0.33–6.86) and 0.93 for DFS(95% CI: 0.35–2.45).Conclusions: In our series, bone marrow positivity didnot correlate with prognostic parameters or prognosis. Ofinterest is the relative excess of positivity whenthe bone marrow was obtained during surgery.