Detection of Carcinoembryonic Antigen Messenger RNA-Expressing Cells in Peripheral Blood 7 Days After Curative Surgery is a Novel Prognostic Factor in Colorectal Cancer
- 132 Downloads
The significance of detection of circulating cancer cells in blood during surgery in patients with colorectal cancer (CRC) remains controversial. Experimental study revealed that the cancer cells injected from the vein disappeared completely until 7 days. The aim of this study was to clarify that the detection of circulating cancer cells in blood taken later than 7 days after curative surgery may be a prognostic factor.
Two hundred consecutive patients with CRC who underwent potentially curative surgery were the subjects. Peripheral blood was collected between 7 and 10 days after resection. Cancer cells were detected using reverse transcriptase-polymerase chain reaction targeting carcinoembryonic antigen (CEA) messenger RNA (mRNA). The median follow-up period was 52 months (range: 34–69 months).
The overall positive incidence of CEA mRNA was 22%. Detection of CEA mRNA was not significantly related to conventional clinicopathological findings. Recurrence has been confirmed in 55 patients (28%). The recurrence rate was significantly higher in patients with rectal cancer, deep penetration, lymph node metastasis, preoperative chemoradiotherapy and positive CEA mRNA. The CEA mRNA positive patients showed significantly poorer disease free survival (DFS) and overall survival (OS) than the negative patients (DFS, P = 0.007; OS, P = 0.04). Multivariate analysis revealed that the positive expression of CEA mRNA (P < 0.01) as well as the tumor location and TNM stage classification was identified as the significant risk factors for recurrence.
Detection of CEA mRNA expressing cells in peripheral blood 7 days after curative surgery is a novel independent factor predicting recurrence in patients with CRC.
KeywordsColorectal cancer Carcinoembryonic antigen (CEA) Circulating tumor cells Reverse transcriptase-polymerase chain reaction (RT-PCR)
- 11.Taniguchi T, Makino M, Suzuki K, Kaibara N. Prognostic significance of reverse transcriptase-polymerase chain reaction measurement of carcinoembryonic antigen mRNA levels in tumor drainage blood and peripheral blood of patients with colorectal carcinoma. Cancer 2000; 89:970–976PubMedCrossRefGoogle Scholar
- 19.Vlems FA, Diepstra JHS, Cornelissen IMHA, et al. Limitations of cytokeratin 20 RT-PCR to detect dissemination tumour cells in blood and bone marrow of patients with colorectal cancer: expression in controls and downregulation in tumour tissue. J Clin Pathol Mol Pathol 2002; 55:156–163CrossRefGoogle Scholar
- 24.Cox DR. Regression models and life tables. J R Stat Soc Br 1972; 34:187–220Google Scholar
- 29.Greene FL, Balch CM, Fleming ID, et al. (eds). (2002) AJCC manual for staging of cancer, 6th edn. Berlin Heidelberg New York:SpringerGoogle Scholar