Abstract
Samples of metastatic prostate cancer to bone are difficult to obtain. The aim of this study was to compare the results of bone marrow aspirate and trephine biopsy for obtaining metastatic hormone-refractory prostate cancer (HRPC) samples using previous diagnostic planar 99mTc-HDP bone scans to guide the procedure. All samples taken were for the purposes of research and molecular studies on HRPC. Twenty patients with HRPC had bone marrow aspirate and trephines taken from lesions in the posterior superior iliac spine or sacro-iliac region when shown on diagnostic 99mTc-HDP bone scans. Three patients also underwent plain X-ray, 18F-positron emission tomography bone scan, pelvic MRI scan and 99mTc nanocolloid bone marrow scans. These images were used to assess if the extra imaging information provided, such as three-dimensional localisation of the bone metastases, was of value for target bone metastases. Cancer cells were obtained in 15/20 (75%) cases in which a trephine biopsy was attempted and 0/20 of cases in which a bone marrow aspiration was attempted. The additional information provided by the range of other imaging investigations was of little benefit in obtaining tumour samples, but did suggest why negative biopsies were obtained in some cases after targeting with planar bone scans. We recommend the use of bone marrow trephine biopsy alone, guided by previous diagnostic 99mTc planar bone scan as a practical method to obtain prostate cancer cells from bone metastases.
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References
Majeed A, Babb P, Jones J, Quinn M . Trends in prostate cancer incidence, mortality and survival in England and Wales 1971–1998 BJU Int 2000 85: 1–5
Alers JC, Kritjenberg P-J, Vissers KJ, van Decken H . Effect of bone decalcification proceedures on DNA in situ hybridization and comparative genomic hybridization: EDTA is highly preferable to a routinely used acid decalcifier J Histochem Cytochem 1999 47: 703–709
Chua DT, Ackermann A, Veenema RJ . Bone marrow biopsy in patients with carcinoma of the prostate J Urol 1969 102: 602–606
Sy FA, Gursel EO, Veenema RJ . Positive random iliac bone biopsy in advanced prostate cancer Urology 1973 11: 125–127
Crisp J . Random bone marrow biopsy in the staging of carcinoma of the prostate Br J Urol 1976 48: 265–267
Spiers ASD, Deal DR, Kasimis BS, Miller BR . Evaluation of the bones and bone marrow in patients with metastatic carcinoma of the prostate: radiological cytologic and cytogenetic findings J Med 1982 13: 303–307
Rohr K, Hegglin R . Tumorzellen im sternalpunktat Deutsch Arch f klin Med 1936 179: 61–79
Alyea EP, Rundles RW . Bone marrow studies in carcinoma of the prostate J Urol 1949 62: 332–339
Clifton JA, Philipp RJ, Ludovic E, Fowler WM . Bone marrow and carcinoma of the prostate Am J Med Sci 1952 224: 121–130
Welch JF, Mackinnery CC . Experience with aspiration biopsies of the bone marrow in the diagnosis and prognosis of carcinoma of the prostate gland Am J Clin Pathol 1964 41: 509–512
Mansi JL et al. Detection of tumour cells in bone marrow of patients with prostatic carcinoma by immunocytochemical techniques J Urol 1988 139: 545–548
Wood Jr DP et al. Identification of bone marrow micrometastases in patients with prostate cancer Cancer 1994 74: 2533–2540
Varenhorst E, Alund G, Lindstrom E, Manson JC . Bone marrow aspiration biopsy and bone scanning in the staging of prostate cancer Br J Urol 1983 55: 534–537
Bearden JD, Ratkin GA, Coltman CA . Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease J Clin Pathol 1974 27: 738–740
Mehan DJ, Broun GO, Hoover B, Storey G . Bone marrow finding in carcinoma of the prostate J Urol 1966 95: 241–244
Nelson CMK, Boatman DL, Flocks RH . Bone marrow examination in carcinoma of the prostate J Urol 1973 109: 667–670
Molino A et al.. A comparative analysis of three different techniques for the detection of breast cancer cells in bone marrow Cancer 1991 67: 1033–1036
Ingle JN, Tormey DC, Tan HK . The bone marrow examination in breast cancer; diagnostic considerations and clinical usefulness Cancer 1978 41: 670–674
Grossmann ME, Huang H, Tindall DJ . Androgen receptor signalling in androgen-refractory prostate cancer J Natl Cancer Inst 2001 93: 1687–1697
Soloway MS et al. Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan Cancer 1988 61: 195–202
Steinborn MM et al. Whole body bone marrow MRI in patients with metastatic disease to the skeletal system J Comput Assist Tomogr 1999 23: 123–129
Algra PR et al. Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy Radiographics 1991 11: 219–232
Schirrmeister H et al. Sensitivity in detecting osseous lesions depends on anatomical localization: planar bone scintigraphy versus 18F PET J Nucl Med 1999 40: 1623–1629
Haddock G et al. 99mTc-Nanocolloid bone marrow scintigraphy in prostate cancer Br J Urol 1989 63: 497–502
Acknowledgements
We would like to thank Dr C Harrison and Dr K Patterson for their help with the training in bone marrow aspiration and trephine procedures.
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Brown, R., Dogan, A., Ell, P. et al. The comparative values of bone marrow aspirate and trephine for obtaining bone scan-targeted metastases from hormone-refractory prostate cancer. Prostate Cancer Prostatic Dis 5, 144–151 (2002). https://doi.org/10.1038/sj.pcan.4500581
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DOI: https://doi.org/10.1038/sj.pcan.4500581