title: Clinical impact of carcinoembryonic antigen messenger ribonucleic acid expression in tumor-draining vein blood on postoperative liver metastasis in patients with colorectal carcinoma: a prospective, cohort study.
abstract: OBJECTIVE
  This study was designed to determine the clinical impact of carcinoembryonic antigen messenger ribonucleic acid expression in tumor-draining vein blood on postoperative liver metastasis in patients with colorectal carcinoma.
  
  
  METHODS
  The study comprised 37 patients with colorectal carcinoma who underwent laparotomy (Dukes A, 3; Dukes B, 16; Dukes C, 15; and Dukes D, 3). Blood samples were drawn from the tumor-draining vein and the tumor-feeding artery. Total ribonucleic acid was extracted from the blood and subjected to reverse transcriptase-polymerase chain reaction to detect carcinoembryonic antigen messenger ribonucleic acid. Tissue sections of tumor were stained with hematoxylin and eosin and were examined immunohistochemically. The duration of follow-up ranged from two years and three months to three years and six months.
  
  
  RESULTS
  Expression of amplified carcinoembryonic antigen messenger ribonucleic acid in tumor-draining vein blood was positive in 16 (43 percent) of the 37 patients, while that in the feeding artery blood was positive in 3 patients (8 percent). There was no relation between the protein level of carcinoembryonic antigen and positive expression of carcinoembryonic antigen messenger ribonucleic acid. Positive expression of carcinoembryonic antigen messenger ribonucleic acid was observed in two patients with histologic evidence of massive venous invasion and in all three patients with synchronous liver metastasis. Immunohistochemical studies revealed that all tumor specimens with stromal type (5/5) of carcinoembryonic antigen staining had positive expression of carcinoembryonic antigen messenger ribonucleic acid. Postoperative liver metastasis was detected in four patients, three of whom (75 percent) had positive expression of carcinoembryonic antigen messenger ribonucleic acid in tumor-draining vein blood.
  
  
  CONCLUSIONS
  Positive expression of carcinoembryonic antigen messenger ribonucleic acid in tumor-draining vein blood differed by the type of immunohistochemical staining with carcinoembryonic antigen. These data suggest that patients with positive expression of carcinoembryonic antigen messenger ribonucleic acid in tumor-draining vein blood may be at a high risk for postoperative liver metastasis.
authors.affiliation: Department of Surgery, Kawakita General Hospital, 1-7-3 Asagaya-kita, Suginami-ku, Tokyo 166-0001, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Sunouchi
authors.forename: Rikuo
authors.initials: R
authors.lastname: Machinami
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Namiki
authors.forename: Shouichi
authors.initials: S
authors.lastname: Hattori
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Murata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Mizuno
authors.forename: Masao
authors.initials: M
authors.lastname: Tadokoro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger