title: Detection of carcinoembryonic antigen messenger RNA-expressing cells in peripheral blood 7 days after curative surgery is a novel prognostic factor in colorectal cancer.
abstract: BACKGROUND
  The significance of detection of circulating cancer cells in blood during surgery in patients with colorectal cancer (CRC) remains controversial. Experimental study revealed that the cancer cells injected from the vein disappeared completely until 7 days. The aim of this study was to clarify that the detection of circulating cancer cells in blood taken later than 7 days after curative surgery may be a prognostic factor.
  
  
  METHODS
  Two hundred consecutive patients with CRC who underwent potentially curative surgery were the subjects. Peripheral blood was collected between 7 and 10 days after resection. Cancer cells were detected using reverse transcriptase-polymerase chain reaction targeting carcinoembryonic antigen (CEA) messenger RNA (mRNA). The median follow-up period was 52 months (range: 34-69 months).
  
  
  RESULTS
  The overall positive incidence of CEA mRNA was 22%. Detection of CEA mRNA was not significantly related to conventional clinicopathological findings. Recurrence has been confirmed in 55 patients (28%). The recurrence rate was significantly higher in patients with rectal cancer, deep penetration, lymph node metastasis, preoperative chemoradiotherapy and positive CEA mRNA. The CEA mRNA positive patients showed significantly poorer disease free survival (DFS) and overall survival (OS) than the negative patients (DFS, P = 0.007; OS, P = 0.04). Multivariate analysis revealed that the positive expression of CEA mRNA (P < 0.01) as well as the tumor location and TNM stage classification was identified as the significant risk factors for recurrence.
  
  
  CONCLUSIONS
  Detection of CEA mRNA expressing cells in peripheral blood 7 days after curative surgery is a novel independent factor predicting recurrence in patients with CRC.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, Japan. sadahiro@is.icc.u-tokai.ac.jp
authors.forename: Sotaro
authors.initials: S
authors.lastname: Sadahiro
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yurimoto
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Akemi
authors.initials: A
authors.lastname: Kamijo
authors.forename: Chieko
authors.initials: C
authors.lastname: Murayama
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000097:blood / Q000556:secondary / Q000601:surgery; D002272:Carcinoembryonic Antigen / Q000235:genetics*; D018279:Carcinoma, Signet Ring Cell / Q000097:blood / Q000556:secondary / Q000601:surgery; D015179:Colorectal Neoplasms / Q000097:blood* / Q000235:genetics / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000601:surgery; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger; D012334:RNA, Neoplasm