Minimal residuale Tumorerkrankung beim Ösophaguskarzinom

Zusammenfassung

Obgleich mikrodisseminierte Tumorzellen in Lymphknoten oder im Knochenmark durch verschiedene Methoden nachgewiesen werden können, ist deren biologische und klinische Relevanz für die Tumorerkrankung nicht restlos geklärt. Die Datenlage hierzu beim Ösophaguskarzinom ist teilweise inkongruent. Letztlich zeigt sich, dass mikrometastatische Tumorzellen in Lymphknoten eine Tumorzellverbreitung repräsentieren, die mit einem signifikant schlechteren Überleben der Patienten verbunden ist und durch das klinisch-pathologische Staging nicht abgebildet wird. Die Wertung von Tumorzellen im Knochenmark ist aufgrund der Heterogenität der Nachweisverfahren und der damit verbundenen diffizilen Validierung insbesondere im Hinblick auf eine klinische Nutzung, z. B. im präoperativen Staging, mit erheblichen Unwägbarkeiten verbunden.

Abstract

Although microdisseminated cancer cells in lymph nodes and in bone marrow can be detected by a variety of methods, their biological and clinical relevance remains unclear. The following article focusing on minimal residual disease in esophageal cancer illustrates and debates numerous publications with reference to this issue. In conclusion, micometastatic cancer cells in lymph nodes indicate systemic spread of disease not reflected by conventional clinical and histological staging, hereby resulting in significantly impaired survival of patients. The detection of cancer cells in bone marrow is clouded by the heterogeneity of their analytic assessment. Consequently, its diagnostic validity seems to be arguable in terms of introduction into clinical practice, e. g. preoperative staging.

minimal residuale Tumorerkrankung - Mikrometastasen - Mikrodisseminierung - Ösophaguskarzinom - Staging

minimal residual disease - micrometastasis - micodissemination - esophageal cancer - staging

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