title: Guanylyl cyclase C messenger RNA is a biomarker for recurrent stage II colorectal cancer.
abstract: BACKGROUND
  Patients with stage II colorectal cancer and no histologic evidence of lymph node invasion develop recurrent disease, presumably because of undetected micrometastases. Guanylyl cyclase C is expressed by intestinal and colorectal cancer cells but not by extraintestinal tissues or tumors.
  
  
  OBJECTIVE
  To examine the expression of guanylyl cyclase C messenger RNA (mRNA) in lymph nodes of patients with node-negative colorectal cancer who did and did not have recurrent disease.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Tertiary care academic medical center.
  
  
  METHODS
  Paraffin-embedded lymph nodes were obtained from 21 patients with histologically confirmed node-negative colorectal cancer who had undergone resection. Controls included 11 patients without disease recurrence 6 or more years after resection, and case-patients included 10 patients whose disease recurred up to 3 years after resection.
  
  
  METHODS
  Sections of paraffin-embedded lymph nodes were obtained from each patient and were pooled, and their RNA was analyzed by reverse transcriptase polymerase chain reaction (RT-PCR).
  
  
  RESULTS
  Guanylyl cyclase C mRNA was expressed in lymph nodes from all patients with recurrent disease but not in those from patients without recurrent disease (P = 0.004). Nested RT-PCR that used primers for carcinoembryonic antigen, a marker for colorectal cancer, identified carcinoembryonic antigen mRNA in lymph nodes from only 1 of 10 patients with recurrent disease and those from 0 of 11 patients without recurrent disease. The odds ratio for death associated with expression of guanylyl cyclase C mRNA in regional lymph nodes was 15.0 (95% CI, 1.1 to 756.7).
  
  
  CONCLUSIONS
  Expression of guanylyl cyclase C mRNA in lymph nodes is associated with recurrence of colorectal cancer in patients with stage II disease. Analysis of guanylyl cyclase mRNA expression by RT-PCR may be useful for colorectal cancer staging.
authors.affiliation: Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: B
authors.initials: B
authors.lastname: Cagir
authors.forename: A
authors.initials: A
authors.lastname: Gelmann
authors.forename: J
authors.initials: J
authors.lastname: Park
authors.forename: T
authors.initials: T
authors.lastname: Fava
authors.forename: A
authors.initials: A
authors.lastname: Tankelevitch
authors.forename: E W
authors.initials: EW
authors.lastname: Bittner
authors.forename: E J
authors.initials: EJ
authors.lastname: Weaver
authors.forename: J P
authors.initials: JP
authors.lastname: Palazzo
authors.forename: D
authors.initials: D
authors.lastname: Weinberg
authors.forename: R D
authors.initials: RD
authors.lastname: Fry
authors.forename: S A
authors.initials: SA
authors.lastname: Waldman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002272:Carcinoembryonic Antigen / Q000032:analysis; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006162:Guanylate Cyclase / Q000032:analysis* / Q000235:genetics; D006801:Humans; D008198:Lymph Nodes / Q000201:enzymology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D012333:RNA, Messenger / Q000032:analysis*; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled; D018000:Receptors, Peptide / Q000032:analysis* / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger; D018000:Receptors, Peptide; D006162:Guanylate Cyclase; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled