Immuno-morphological characteristics of bone marrow in patients with ovarian cancer

Abstract

Background. Nowadays, one of the promising areas is the study of bone marrow in malignant tumors. It is known that hematogenous metastasis to the bone marrow in cancer is a common event. Identification of bone marrow lesions in ovarian cancer, as well as the study of hematopoiesis, can provide additional information about the features of metastasis of this tumor and will make it possible to assess the prospects for targeted therapy.
 Aim. To assess the possibility of detecting disseminated tumor cells in the bone marrow in patients with ovarian cancer, to establish the frequency of bone marrow damage and to analyze the relationship with the clinical and morphological parameters of the tumor.
 Materials and methods. This work includes 42 patients with ovarian cancer who received treatment at the Blokhin National Medical Research Center of Oncology. The study was carried out by morphological and immunological methods. Morphological examination of the bone marrow (counting myelograms, calculating myelogram indices, detection of tumor cells) was performed by two morphologists. Disseminated tumor cells were detected using flow cytometry (FACS Canto II, USA, Kaluza Analysis v2.1 software). Monoclonal antibodies were used: CD45, EPCAM.
 Results. Disseminated tumor cells in the bone marrow of patients with ovarian cancer were determined based on the expression of the EPCAM antigen and lack of expression of CD45 antigen. Disseminated tumor cells were found in 65.2% (n=15)of bone marrow aspirates. Disseminated tumor cells did not correlate with tumor size, lymph nodes status and stage. The frequency of bone marrow damage was higher at stage III and reached 78.6% (11 out of 14 patients), while it was 33.3% (1 of 3 patients) in stage I. 40.0% of positive cases (2 out of 5 patients) were detected at stage IV. Disseminated tumor cells were found in 78.6% (n=11) of bone marrow aspirates in primary ovarian cancer, while in recurrent ovarian cancer they were found only in 44.4% (n=4).
 Conclusion. The hematogenous dissemination of ovarian cancer in the bone marrow was established. Bone marrow lesions was noted even in the early stages of the tumor process. The frequency of detection of disseminated tumor cells in the bone marrow of patients with ovarian cancer was 65.2%. More frequent bone marrow damage was noted in primary ovarian cancer. The number of myelocytes was significantly lower in primary ovarian cancer without bone marrow damage. The number of lymphocyte was lower in cases of bone marrow lesions.