Viability of Free Malignant Cells in Specimens Removed because of Colorectal Carcinoma

Akira Tsunoda, Miki Shibusawa, Gouichi Kamiyama, Manabu Takada, Noboru Yokoyama, Mitsuo Kusano

Department of Surgery, School of Medicine, Showa University

Papanicolau smear preparations of mucus from the lining surface of 19 colon specimens removed because of carcinoma were examiend. At a distance of 5 cm or more from the tumor, 67-75% of the smears were positive, while 100% contained malignant cells if the smears were taken less than 5 cm from the tumor. Then the viability of tumor cells shed into the intestinal lumen was determined in the patients with colorectal carcinoma. Fifteen operative specimens were irrigated. The resulting cell specimens were centrifuged on a Nycodenz linear density gradient column so that tumor cells were concentrated in a band at the top. In 13 of the l5 proximallumen specimens a median of 0.66×l0⁵ tumor cells werere covered, with a median percentage viability of 79. In 5 specimens examined, the neoplastic cells showed fluorescence. In 12 of the 15 distal lumen specimens a median of 0.27×10⁵ tumor cells were recovered with a median percentage viability of 83, and fluorescence was observed in 3 specimens examined. Thus viable exfoliated tumor cells were demonstrated. Their presence in large numbers at the site of an intestinal anastomosis supports their potential role in the etiology of suture line recurrence.

Key words
implantation metastasis of colorectal carcinoma, viability of free malignant cells

Reprint requests
Akira Tsunoda Department of Surgery, School of Medicine, Showa University
1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142 JAPAN

Accepted
January 10, 1996

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