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Cancer Cell Exfoliation by Preoperative Colonoscopic Examination
Author(s) -
Tomiki Yuichi,
Kamano Toshiki,
Hayashida Yasuo,
Okada Tsuyoshi,
Kunii Yasuhiro,
Ishibiki Yoshiro,
Kawase Yoshihiko,
Tsurumaru Masahiko
Publication year - 2000
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2000.00075.x
Subject(s) - medicine , endoscope , forceps , trypan blue , colorectal cancer , papanicolaou stain , biopsy , staining , cancer cell , cancer , pathology , stain , curette , surgery , cell , cervical cancer , biology , genetics
Background: Colonoscopic contact and repeated biopsies have been associated with an increased risk of cancer cell dissemination. We examined whether exfoliated cancer cells were detected during preoperative colonoscopic examination in patients with colorectal cancer. Methods: Twenty‐five patients with colorectal cancer were studied. Samples were collected by four methods: intestinal lavage solution, endoscope tip, forceps channel ( n = 22) and biopsy forceps ( n = 3). The collected suspensions were centrifuged, fixed in 95% ethanol, stained with Papanicolaou stain and examined microscopically. Viability of the exfoliated cancer cells was studied in five patients. Samples obtained by endoscope tip and forceps channel were suspended in RPMI 1640 medium supplemented with 10% fetal calf serum stained with trypan blue or fluorescent dye and examined. Results: Exfoliated cancer cells were detected in 18 of 25 patients (72%). The detection rate was 45.5% in intestinal lavage solution, 68.2% at the endoscope tip and 81.8% in the forceps channel. The detection rate of exfoliated cancer cells adhering to the colonoscope depended on endoscopic contact ( P = 0.009). Trypan blue staining and fluorescent staining confirmed the presence of viable cells among the exfoliated cancer cells. Conclusion: Our findings indicate that cancer cells were exfoliated when the colonoscope passed through a stricture and after biopsy or passage of a colonoscope through a stricture, further manipulation of lesions should be avoided to reduce the risk of implantation metastasis.