Prognostic significance of epithelial cells in the blood of patients with gynaecological malignancies.

BACKGROUND: Some studies have shown that the detection of epithelial cells in peripheral blood indicates minimal residual disease status. There is a lack of data concerning the prognostic relevance of the detection of epithelial cells in the blood of patients with solid tumors. Therefore, we conducted the present study to analyse the relationship between the detection of epithelial cells in the blood, "conventional" prognosis factors and overall survival in patients with gynaecological malignancies. MATERIALS AND METHODS: In a prospective study we investigated blood samples of patients with benign and malignant gynaecologic diseases from 11/97 to 03/99. We used an immunocytochemical approach using cytokeratin-directed antibodies CK 8-18 in 135 and A45-B/B3 in another 123 patients for detection of epithelial cells. Follow-up was obtained by checking the local tumor register and contact with all patients included in the study. RESULTS: There was no significant correlation between detection rate and tumour stage, grading or lymph node status. The median time of follow-up was 45.9 (range 0.7-63) months. There was no significant correlation between the detection rate of positive epithelial cells (method A + B) and overall survival. CONCLUSION: The results of this study underline the need to further investigate the role of disseminated tumor cells in the blood and bone marrow of patients with gynaecological malignancies.

Detection of epithelial carcinoma cells in the blood of patients with gynaecological malignancies.

BACKGROUND: Some investigations have shown that evidence of epithelial tumor cells in bone marrow is a relevant prognostic factor in various solid tumors. However there is a lack of data concerning the value of detection methods for epithelial cells in the serum of cancer patients. MATERIALS AND METHODS: In a prospective study we investigated the blood samples of patients with benign and malignant gynaecological diseases from November 1997 to March 1999. We used an immunocytochemical approach with cytokeratin-directed antibodies CK 8-18 in 135 and A45-13/133 in another 123 patients for detection of epithelial cells. RESULTS: There was no significant correlation between the detection rate and tumour stage, grading or lymph node status. The CK8-18 antibody had a higher detection rate for epithelial cells than A45-B/B3 (52% vs. 10%). CONCLUSION: Both methods showed a low sensitivity and a high specificity. Further studies are needed to determine the prognostic value of epithelial cells in the blood of patients with gynaecological malignancies.