Transurethral Bladder Tumor Resection Can Cause Seeding of Cancer Cells into the Bloodstream
Transurethral Bladder Tumor Resection Can Cause Seeding of Cancer Cells into the Bloodstream
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DOI：
10.1016/j.juro.2014.06.083
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发表时间：
2015-01-01
影响因子：
6.6
通讯作者：
Gudjonsson, Sigurdur
中科院分区：
文献类型：
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作者：
Engilbertsson, Helgi;Aaltonen, Kristina E.;Gudjonsson, Sigurdur
目的：经尿道膀胱肿瘤电切术是膀胱癌的首选诊断方法。假设肿瘤切除可以诱导癌细胞进入循环和随后的转移性疾病。在这项研究中，我们确定了经尿道膀胱肿瘤电切术是否诱导了可测量的癌细胞进入血管系统。材料和方法：本研究纳入2012-2013年间新诊断为浸润性膀胱癌并计划行经尿道膀胱肿瘤电切术的患者。在经尿路膀胱肿瘤切除术前，血管外科医生通过股静脉在下腔静脉放置了一根静脉导管。在切除前和切除期间，从下腔静脉和外周静脉抽取血液样本，并使用CellSearch(R)系统分析循环癌细胞。比较术前和术中血样中检测到的循环肿瘤细胞数。结果：分析了16例符合条件的患者循环肿瘤细胞数据。在7例阳性的下腔静脉标本中，6例(86%)术中循环中肿瘤细胞数量增加(28vs9，28vs0，28vs5，3vs0，4vs0，1v0)，与相应的外周静脉标本结果相似，但不具说服力。结论：我们的研究证实，在经尿道膀胱肿瘤切除术中，肿瘤细胞可以释放到循环中。目前尚不清楚这是否会增加转移疾病的风险。
Purpose: Transurethral bladder tumor resection is the initial diagnostic procedure for bladder cancer. Hypothetically tumor resection could induce seeding of cancer cells into the circulation and subsequent metastatic disease. In this study we ascertain whether transurethral bladder tumor resection induces measurable seeding of cancer cells into the vascular system.Materials and Methods: Patients newly diagnosed with suspected invasive bladder cancer and planned for transurethral resection of bladder tumor in 2012 to 2013 were enrolled in the study. Before transurethral bladder tumor resection a vascular surgeon placed a venous catheter in the inferior vena cava via the femoral vein. Blood samples were drawn before and during the resection from the inferior vena cava and a peripheral vein, and analyzed for circulating cancer cells using the CellSearch (R) system. The number of circulating tumor cells identified was compared in preoperative and intraoperative blood samples.Results: The circulating tumor cell data on 16 eligible patients were analyzed. In 6 of 7 positive inferior vena cava samples (86%) the number of circulating tumor cells was increased intraoperatively (28 vs 9, 28 vs 0, 28 vs 5, 3 vs 0, 4 vs 0, 1 vs 0), and results were similar, although less conclusive, for the corresponding peripheral vein samples.Conclusions: Our study confirms that tumor cells can be released into the circulation during transurethral bladder tumor resection. It is currently unknown whether this will increase the risk of metastatic disease.