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An Explanation of Blood Transfusion Enhancement of Tumor Growth

Robert L. Quigley, MD, DPhil

Arch Surg. 1996;131(4):438-441.

Abstract
Objective
To determine the mechanism of the adverse relationship between perioperative blood transfusion and lung cancer recurrence, by focusing on endothelial cell adhesion molecules (CAMs), which are thought to play a role in distant tumor cell implantation.

Design and Outcome Measures
Murine endothelial cells were cocultured with allogeneic leukocytes, syngeneic leukocytes, and syngeneic lung carcinoma cells for 60 hours. The percentage of endothelial cells expressing vascular CAMs (VCAMs) and intercellular CAMs (ICAMs) was quantified during this time using indirect immunofluorescence and flow cytometry. Tumor cell adhesion to the endothelium was quantified for 6 hours using cells labeled with sulfur 35 and a scintillation counter.

Setting
Laboratory.

Materials
C57/BL and Balb/C mice.

Results
Vascular CAM was not expressed on the endothelium, but ICAM was preferentially expressed without stimulation. Tumor-cell adhesion and endothelial ICAM expression were inversely related. After 15 hours of coculture, tumor cell adhesion was fourfold greater in the experimental group than in the control, and coincident endothelial ICAM expression was fourfold lower.

Conclusion
Endothelial cell ICAM expression is negatively correlated with metastatic potential.

(Arch Surg. 1996;131:438-441)

Author Affiliations
From the Research Laboratories of Evanston (Ill) Hospital. Dr Quigley is now with the Department of Surgery, Cardiothoracic Section, Guthrie Clinic, Sayre, Pa.

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