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Journal of Histochemistry and Cytochemistry, Vol. 47, 1075-1088, August 1999, Copyright © 1999, The Histochemical Society, Inc.

ARTICLE

Effects of Different Immunolabeling Techniques on the Detection of Small-cell Lung Cancer Cells in Bone Marrow

Giuseppe Pelosia, Felice Pasinib, Flavia Pavanelb, Enrica Bresaolac, Ivana Schiavond, and Antonio Iannuccid
a Institute of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
b Institutes of Medical Oncology, University of Verona, Verona, Italy
c Pathology, University of Verona, Verona, Italy
d Institute of Pathology, Ospedale Civile Maggiore, Verona, Italy

Correspondence to: Giuseppe Pelosi, Divisione di Anatomia Patologica e Medicina di Laboratorio, Istituto Europeo di Oncologia, Via G. Ripamonti 435, I-20141 Milano, Italy.

Recent reports have suggested that the immunodetection of tumor cells in bone marrow of small-cell lung cancer (SCLC) patients is by far more effective than traditional cytohistological methods and that this may be clinically relevant. This study aimed to evaluate whether the level of detection of tumor cells in bone marrow is affected by different immunostaining methods. Using two anti-NCAM monoclonal antibodies (MAbs), we compared four different "sandwich" methods on cytospin preparations of the N592 human SCLC cell line and of bone marrow aspirates from 37 SCLC patients. Our data indicate that the combination of the alkaline phosphatase–anti-alkaline phosphatase and streptavidin–biotin–alkaline phosphatase complex methods provides the best results in terms of sensitivity and specificity, and of intensity of immunoreaction and absence of staining background. Moreover, bone marrow micrometastases detected by this method were prognostically relevant and identified, among patients with apparently limited disease according to conventional staging procedures, a subgroup with shorter survival. We suggest that the choice of a sensitive immunostaining technique may significantly increase the detection rate of SCLC cells in bone marrow, mirroring the biological aggressiveness of the disease. (J Histochem Cytochem 47:1075–1087, 1999)

Key Words: small-cell lung cancer, bone marrow, immunocytochemistry, alkaline phosphatase, amplification, prognosis


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