Intraoperative molecular detection of circulating tumor cells by reverse transcription-polymerase chain reaction in patients with biliary-pancreatic cancer is associated with hematogenous metastasis.
BACKGROUND
Circulating tumor cells in the blood were frequently detected by reverse transcription-polymerase chain reaction during operation in patients with biliary-pancreatic cancer. We investigated the relationship between circulating tumor cells during operation and hematogenous metastases.


METHODS
Blood samples from 67 patients with biliary-pancreatic cancer were obtained from the portal vein, peripheral artery, and superior vena cava during operation. After total RNA was extracted from each blood sample, carcinoembryonic antigen (CEA)-specific reverse transcription-polymerase chain reaction was performed.


RESULTS
Intraoperative CEA-messenger RNA (mRNA) expression was detected in the blood of 32 (47.8%) of 67 patients with biliary-pancreatic cancer, although it was not detected in the blood obtained from 20 healthy volunteers or 15 patients with benign disease of the biliary pancreas. The incidence (37.5%) of hematogenous metastases after surgery in the CEA-mRNA-positive group (n = 32) was significantly higher than that (11.4%) in the negative group (n = 35; P =.01). In stage I, II, and III patients, survival of the CEA-mRNA-positive group was significantly worse compared with that of negative group (P =.03).


CONCLUSIONS
Intraoperative molecular detection of circulating tumor cells in patients with biliary-pancreatic cancer relates to a high risk of hematogenous metastasis and is associated with unfavorable prognosis even after curative resection.
Uchikura
Keiichiro
K
First Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan.
Takao
Sonshin
S
Nakajo
Akihiro
A
Miyazono
Futoshi
F
Nakashima
Saburou
S
Tokuda
Kouki
K
Matsumoto
Masataka
M
Shinchi
Hiroyuki
H
Natsugoe
Shoji
S
Aikou
Takashi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012333:RNA, Messenger / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger