Evaluation of cytokeratin-19 mRNA as a tumor marker in the peripheral blood of nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy.
The reverse transcriptase-polymerase chain reaction (RT-PCR) technique is a tool capable of detecting minute quantities of circulating tumor cell-derived transcripts. Nasopharyngeal carcinoma (NPC) is a rapidly growing tumor of epithelial origin and high metastatic potential. The aim of our study is to investigate the clinical value of circulating cytokeratin-19 (CK-19) mRNA detection in NPC patients. Between June 1997 and March 1999, 57 previously untreated, advanced NPC patients without distant metastasis were uniformly treated by concurrent chemoradiotherapy. Peripheral blood samples were collected prospectively before treatment and subjected to a nested RT-PCR assay. Measures were taken to prevent contamination and pseudogene interference. PCR products of positive results were verified by restriction enzyme Hae II and direct sequencing. Under our nested RT-PCR experimental conditions, 33.3% (19/57) clinically nonmetastatic NPC patients had CK-19 mRNA in their blood. The positive detection rates of CK-19 mRNA in the peripheral blood for different stages were 20.0% for stage II, 31.6% stage III and 43.5% stage IV (p = 0.1335). After a median follow-up time of 35 months, 2 patients had recurrences of their primary tumors and 14 developed distant metastases without locoregional recurrence. Nine of 19 (47.4%) CK-19 mRNA-positive patients and 5 of 38 (13.2%) CK-19 mRNA-negative patients developed distant metastasis (p = 0.00826). The 3-year metastasis-free survival rates were 49.9% for patients with detectable CK-19 and 85.9% for those with undetectable CK-19 (p = 0.0089, log-rank test). Our data suggest that the presence of CK-19 mRNA in the peripheral blood may be a potential marker of micrometastasis for NPC.
Lin
Jin-Ching
JC
Institute of Clinical Medicine, College of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China. jclin@vghtc.vghtc.gov.tw
Chen
Kuang Y
KY
Wang
Wen-Yi
WY
Jan
Jian-Sheng
JS
Liang
Wen-Miin
WM
Wei
Yau-Huei
YH
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000737:chemistry / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D005189:False Positive Reactions; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007633:Keratins / Q000032:analysis / Q000235:genetics*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000097:blood* / Q000737:chemistry / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000032:analysis / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011544:Pseudogenes; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D007633:Keratins; D002945:Cisplatin; D005472:Fluorouracil