Prognostic relevance of disseminated tumour cells in bone marrow of patients with transitional cell carcinoma

ObjectiveThis prospective study is the first immunocytochemical investigation of the frequency and prognostic value of CK+ tumour cells in the bone marrow of patients with transitional cell carcinoma (TCC).MethodsBone marrow aspirates from 228 TCC patients were taken preoperatively. Cytospins were made and stained by immunocytochemistry using the monoclonal antibodies CK2 and A45-B/B3. 27 patients with no evidence of any malignant disease served as control group.ResultsCK+ tumour cells were detected in 28% (63/228) of the TCC patients. No CK+ cells (0/27) were detected in the control group. In multivariate analysis the detection of ⩾3 CK+ cells in bone marrow was an independent prognostic factor (hazard ratio = 2.7, p < 0.05) in patients with T2–4 tumour classification.ConclusionDisseminated CK+ cells play a role in the biology of tumour spread of TCC, and their immunocytochemical detection can be useful in assessing the prognosis of TCC patients with an invasive tumour.