Der Nachweis von Cytokeratin 20 im Blut von Patienten mit Magenkarzinomen ist ein unabhängiger Prognoseparameter

Abstract

Detection of Cytokeratin 20 (CK20) in the blood of gastric cancer patients is an indicator for disseminated tumor cells (DTC) and minimal residual disease (MRD). Even after curative resection DTC can be detected in different body compartments. These DTC are discussed to be a reason for a relapse of the disease. This study investigates the prognostic impact of DTC in the blood of gastric cancer patients. The blood of 63 patients with stomach cancer was screened for DTC by means of a CK20 RT-PCR immediately before surgical approach. 40/63 patients were curative resected (R0 = 63,5%). From 40 curative resected patients 15 were positive for CK20 (37,5%) and 25 were negative; after palliative resection 11/23 patients were positive for CK20 (47,8%). Overall survival in both curative and negative resected patients was significant better for those who were negative for CK20 (60,4% survival after 45 month) compared to those patients beeing positive for CK20 (27,2% survival after 45 month; p = 0,03 log rank). Subgroup analysis in curative resected patients only revealed a significant longer overall survival in CK20 negative patients compared to CK20 positive patients (86% vs. 40,4%; p = 0,03 log rank). Thus, expression of CK20 in blood of gastric cancer patients is an independent marker of prognosis.