Detection of carcinoembryonic antigen messenger RNA-expressing cells in portal and peripheral blood during surgery does not influence relapse in colorectal cancer.
BACKGROUND
No consensus has been reached on whether cancer cells detected in blood during colorectal cancer (CRC) surgery may serve as a prognostic indicator.


METHODS
One hundred patients with CRC who underwent curative surgery were the subjects. Portal and peripheral blood were collected immediately after celiotomy and examined for carcinoembryonic antigen (CEA) messenger RNA (mRNA) by using competitive semi-nested reverse transcriptase-polymerase chain reaction. The median follow-up period was 59 months (range, 49-74 months).


RESULTS
Until now, recurrence has been confirmed in 13 patients (13%). The 4-year recurrence rate was 6.7% (3 of 45) in patients with CEA mRNA-positive portal blood and 20.8% (10 of 48) in patients with CEA mRNA-negative portal blood (P = .09); it was 5.6% (2 of 36) and 19.3% (11 of 57) in patients with CEA mRNA-positive peripheral blood and CEA mRNA-negative blood, respectively (P = .12). There was no difference in disease-free survival between the CEA mRNA-positive and -negative groups. The multivariate analysis showed that the presence of tumor cells in portal or peripheral blood was a factor that reduced recurrence. The relative risks were .17 (P = .01) for the portal vein and .24 (P = .07) for the peripheral vein.


CONCLUSIONS
The detection of cancer cells in blood taken during surgery is not considered to be a poor-prognostic factor in CRC.
Sadahiro
Sotaro
S
Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan. sadahiro@is.icc.u-tokai.ac.jp
Suzuki
Toshiyuki
T
Ishikawa
Kenji
K
Saguchi
Takeshi
T
Maeda
Yuji
Y
Yasuda
Seiei
S
Makuuchi
Hiroyasu
H
Yurimoto
Satoshi
S
Murayama
Chieko
C
D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D007432:Intraoperative Period; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011169:Portal Vein / Q000737:chemistry / Q000378:metabolism*; D011379:Prognosis; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger