The detection of oesophageal adenocarcinoma by serum microsatellite analysis.
OBJECTIVE
Organ-confined oesophageal cancer in an early stage can be cured in many patients, whereas more extensive lesions have a poor prognosis. We sought to develop a non-invasive test for cancer detection and evaluation of the prognosis of the patients by using a novel molecular approach.


METHODS
Matched normal-, tumour- and serum-samples were obtained from 32 patients with adenocarcinoma of the oesophagus. DNA was extracted and the samples were subjected to microsatellite analysis using 12 markers. Serum and normal samples from 10 healthy individuals served as controls.


RESULTS
Twenty-seven of the 32 patients (84.4%) with malignant tumours were found to have one or more microsatellite DNA alterations in their primary tumour. Twenty-six of the 32 patients (81.3%) had alterations in the serum by microsatellite analysis. Interestingly, all patients without lymphatic metastasis and three early carcinomas (pT1pN0) already displayed LOH alteration in the serum, while all serum DNA of samples from normal control subjects were negative. Survival was not significantly correlated with either LOH in the tumour or LOH in the serum.


CONCLUSIONS
These data suggest that microsatellite DNA analysis in serum specimens might provide a potentially valuable tool for early detection of oesophageal cancer. The evidence of circulating tumour DNA reflects the propensity of these tumours to spread to distant sites. Up to now the follow-up is still too short to draw further conclusions on the prognostic impact of this finding.
Department of General Surgery, University Hospital Duesseldorf, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany. eisenberger@uni-duesseldorf.de <eisenberger@uni-duesseldorf.de>
C F
CF
Eisenberger
N H
NH
Stoecklein
S
S
Jazra
S B
SB
Hosch
M
M
Peiper
P
P
Scheunemann
J Schulte
JS
Am Esch
W T
WT
Knoefel
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000235:genetics*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004273:DNA, Neoplasm / Q000235:genetics; D004938:Esophageal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D017491:Genes, APC; D019942:Genes, p16; D016158:Genes, p53; D006801:Humans; D019656:Loss of Heterozygosity; D008297:Male; D018895:Microsatellite Repeats / Q000235:genetics*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm