Amir Sherif med kollegor har publicerat en artikel som visar att flödescytometri kan användas för detektion av lymfkörtelmetastaser vid njurcancer. Extra intressant är att metoden kunde detektera metastaser i körtlar som friats av patologen. I vilken utsträckning metoden kommer att användas i rutinsjukvård återstår att se. Större studier pågår.
Nedan följer Abstract för artikeln på engelska:
Background: Stage is an important prognostic factor in renal tumours and dissemination to regional lymph nodes is associated with poor outcomes. Lymph nodes are routinely assessed by immunohistochemistry and microscopic evaluation, a timeconsuming process where micrometastases might go undiagnosed. We evaluate an alternative method for detecting metastatic cells in sentinel nodes (SNs) by flow cytometry.
Methods: A total of 15 nodes from 5 patients diagnosed with renal tumours were analysed by flow cytometry. Staining for the intracellular marker cytokeratin 18 (CK18) with the surface markers carbonic anhydrase IX (CA9) and Cadherin 6 were used in flow cytometry analysis. Peripheral blood mononuclear cells (PBMCs) with the addition of known concentrations of cancer cell lines were analysed to investigate the sensitivity of micrometastasis detection.
Results: Stability of the assay was marked by low intra-assay variability (coefficient of variancep16%) and low inter-assay variability (R2¼0.9996–1). Eight nodes in four patients were positive for metastasis; six of them were considered being micrometastatic. These metastases were undetected by routine pathology and the patients were restaged from pN0 to pN1.
Conclusions: Flow cytometry is able to detect micrometastases in lymph nodes of renal tumour patients that were undetected under H&E examination.