STUDIES ON CIRCULATING TUMOR CELLS IN PATIENTS WITH BLADDER CANCER

Abstract

In 40 patients with bladder cancer (transitional cell carcinoma, 35; squamous cell carcinoma, 5), the detection of circulating tumor cells has been studied by a filter membrane method. Blood samples (4ml) were simultaneously collected from the antecubital and iliac veins before, during and after partial cystectomy, transurethral fulguration or electroresection through the open bladder. The obtained blood samples were added to 5ml of saline solution containing 20mg of Streptolysin S (INF-fraction, 1, 500×10⁴-HU/g); after 20 minutes of incubation at 37°C, they were then centrifugated at 1, 000r.p.m. for 10 minutes, and the sediments were mixed evenly with 15ml of saline solution. Using a vacuum-pressure pump, these mixtures were filtrated through a Sartorius membrane filter (φ47mm, pore size 10μ). The membranes were fixed, stained (H-E) and subjected to microscopic examination. The results obtained were as follows:
1. Before operation, the positive rates of circulating tumor cells in antecubital and iliac blood samples were 7 and 17 per cent, respectively.
2. During surgical intervention, both rates increased to 38 and 35 per cent, respectively. In 27 cases of a histologically low malignant tumor (stage A), the rate in the iliac samples was 33 per cent, while no tumor cells were detected in the antecubital samples. Ten cases undergoing transurethral fulguration showed a rate of 30 per cent in iliac samples.
3. The tumor cell-positive iliac samples had cells ranging in number from 2 to 195. Among these samples, however, there were only 2 cases which contained more than 10 cells per 1ml of blood.
4. There was no interrelation between the prognosis and the rates. However, the fact that even transurethral fulguration, which was generally performed on small and low malignant tumors, caused the appearance of circulating tumor cells would indicate the administration of antitumor drugs.