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.
BACKGROUND
The objective of this study was to assess the prognostic value of detecting circulating tumor cells in the tumor drainage blood and peripheral blood of patients with colorectal carcinoma.


METHODS
A total of 53 patients with advanced colorectal carcinoma were studied. Tumor drainage blood and peripheral blood samples that were obtained during surgery were examined for carcinoembryonic antigen (CEA) mRNA using reverse transcriptase-polymerase chain reaction (RT-PCR).


RESULTS
In spiking experiments, the assay indicated a sensitivity limit of 1 carcinoma cell per 10(6) cells. CEA mRNA was detected in the tumor drainage blood of 36 of 53 patients (68%) and in the peripheral blood of 18 of 53 patients (34%). The rate of detection in both tumor drainage blood and peripheral blood was significantly higher in patients with lymph node metastasis, lymphatic invasion, or vascular invasion (P < 0.05). Among those patients who underwent potentially curative resection, the 2-year disease free survival rate of patients whose tumor drainage or peripheral blood was negative for CEA mRNA was significantly better than that of patients who showed CEA mRNA positivity of either sample (tumor drainage blood: 100% vs. 57%; P < 0.05; peripheral blood: 74% vs. 50%; P < 0.01), although the follow-up thus far has been only 9-30 months.


CONCLUSIONS
The presence of CEA mRNA in the blood is a useful indicator of circulating tumor cells, and it is one of the determinant prognostic factors for patients with colorectal carcinoma. Moreover, the absence of CEA mRNA in tumor drainage blood was found to be a superior marker for disease free survival compared with that in peripheral blood.
Taniguchi
T
T
First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan. TETSU@grape.med.tottori-u.ac.jp
Makino
M
M
Suzuki
K
K
Kaibara
N
N
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood* / Q000235:genetics; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D014407:Tumor Cells, Cultured
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger