Detection of survivin-expressing circulating cancer cells (CCCs) in peripheral blood of patients with gastric and colorectal cancer reveals high risks of relapse.
BACKGROUND
We previously demonstrated that the detection of circulating cancer cells (CCCs) expressing survivin mRNA could provide valuable information for predicting metastasis and recurrence in breast cancer. The objective of this study was to investigate whether or not the detection of survivin expression in the peripheral blood could also have significant effects on the clinical outcomes of patients with gastric and colorectal cancer.


METHODS
Survivin-expressing CCCs in peripheral blood samples obtained from 55 gastric cancer patients, 86 colorectal cancer patients, and 87 healthy volunteers were quantitatively examined by using a RT-PCR ELISA. Its clinical significance was statistically evaluated.


RESULTS
The CCCs in the peripheral blood samples were detected in 45.4% and 44.0% of gastric and colorectal cancer patients, respectively. The presence of survivin-expressing CCCs was found to be significantly associated with the degree of tumor penetration, nodal status, and disease stages for both types of cancers. During a follow-up period of 36 months, patients who had a positive detection at the time of the initial assay test had a higher relapse rate than those who had a negative detection. As well, survivin-expressing CCCs were statistically shown to be a significant and independent predictor for cancer recurrence. The detection of survivin-expressing CCCs was also demonstrated to be more accurate in terms of predicting recurrence than traditional detection methods such as plasma carcinoembryonic antigen (CEA) measurements.


CONCLUSIONS
The detection of CCCs expressing survivin mRNA could be used to accurately identify gastric and colorectal cancer patients with high risks of relapse.
Yie
Shang-mian
SM
Core Laboratory, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, 32 Yi Huan Lu Xi Er Duan 610078, Chengdu, Sichuan, People's Republic of China. shangmian.yie@gmail.com
Lou
Be
B
Ye
Shang-rong
SR
Cao
Mei
M
He
Xu
X
Li
Ping
P
Hu
Kang
K
Rao
Lin
L
Wu
Sheng-min
SM
Xiao
Hai-Bo
HB
Gao
En
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics; D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood* / Q000235:genetics / Q000556:secondary; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008207:Lymphatic Metastasis; D008297:Male; D008869:Microtubule-Associated Proteins / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000235:genetics / Q000473:pathology; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood* / Q000235:genetics; D012334:RNA, Neoplasm / Q000097:blood* / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000235:genetics / Q000556:secondary; D000077022:Survivin
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D000077022:Survivin