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Cellular composition of stent-penetrating tissue.
Rainer W Hauck1, Marius Barbur, Rolf Lembeck
1Medizinische Klinik II, Städtisches Krankenhaus Bad Reichenhall, Technische Universität, Munich, Germany. hauck@krankenhaus-bad-reichenhall.de
Chest
|November 12, 2002
Summary
Stent implantation significantly reduced intact tumor cells (ITCs) by exerting radial and shear forces, improving airway patency in patients with exophytic lesions. This suggests mechanical forces from stents can impact tumor growth.
Area of Science:
- Interventional Pulmonology
- Oncology
- Biomedical Engineering
Background:
- Exophytic lesions treated with uncovered metal stents show low restenosis rates (<20%) despite significant stenosis (>75%).
- The localized influence of radial stent forces on tumor growth remains largely uninvestigated.
Purpose of the Study:
- To investigate the impact of radial stent forces on intraluminal tumor growth.
- To assess changes in intact tumor cells (ITCs) and airway patency following stent implantation.
Main Methods:
- Histological analysis of intraluminal tumor tissue in 17 patients before and 1 week after stent implantation.
- Quantification of intact tumor cells (ITCs) versus necrotic and non-tumor cells.
- Assessment of airway patency via fiberoptic bronchoscopy.
Main Results:
- A significant reduction in ITCs was observed post-stent implantation (p < 0.03), with 7 patients showing no ITCs.
- Initial stenoses were >75% in all patients, with varying ITC percentages.
- Airway patency significantly improved from 10% to 90.6% (p < 0.0001).
Conclusions:
- Radial and shear stress forces from stents likely reduce ITC viability by compromising tumor stroma blood supply and nutrients.
- Stent implantation demonstrates a profound reduction in ITCs and improved airway patency.
- Mechanical forces exerted by stents can influence tumor growth dynamics.