title: Prognostic relevance of occult nodal micrometastases and circulating tumor cells in colorectal cancer in a prospective multicenter trial.
abstract: OBJECTIVE
  Nodal micrometastasis and circulating tumor cells detected by multimarker quantitative real-time reverse transcription-PCR (qRT-PCR) may have prognostic importance in patients with colorectal cancer.
  
  
  METHODS
  Paraffin-embedded sentinel lymph nodes from 67 patients and blood from 34 of these patients were evaluated in a prospective multicenter trial of sentinel lymph node mapping in colorectal cancer. Sentinel lymph nodes were examined by H&E staining and cytokeratin immunohistochemistry. Sentinel lymph nodes and blood were examined by a four-marker qRT-PCR assay (c-MET, melanoma antigen gene-A3 family, beta1-->4-N-acetylgalactosaminyltransferase, and cytokeratin-20); qRT-PCR results were correlated with disease stage and outcome.
  
  
  RESULTS
  In H&E-negative sentinel lymph node patients that recurred, cytokeratin immunohistochemistry and qRT-PCR detected metastasis in 30% and 60% of patients, respectively. Disease-free survival differed significantly by multimarker qRT-PCR upstaged sentinel lymph node (P = 0.014). qRT-PCR analysis of blood for circulating tumor cells correlated with overall survival (P = 0.040).
  
  
  CONCLUSIONS
  Molecular assessment for micrometastasis in sentinel lymph node and blood specimens may help identify patients at high risk for recurrent colorectal cancer, who could benefit from adjuvant therapy.
authors.affiliation: Department of Molecular Oncology, John Wayne Cancer Institute, Santa Monica, California 90404, USA.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Koyanagi
authors.forename: Anton J
authors.initials: AJ
authors.lastname: Bilchik
authors.forename: Sukamal
authors.initials: S
authors.lastname: Saha
authors.forename: Roderick R
authors.initials: RR
authors.lastname: Turner
authors.forename: David
authors.initials: D
authors.lastname: Wiese
authors.forename: Martin
authors.initials: M
authors.lastname: McCarter
authors.forename: Perry
authors.initials: P
authors.lastname: Shen
authors.forename: Linda
authors.initials: L
authors.lastname: Deacon
authors.forename: David
authors.initials: D
authors.lastname: Elashoff
authors.forename: Dave S B
authors.initials: DS
authors.lastname: Hoon
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D000951:Antigens, Neoplasm / Q000096:biosynthesis; D014408:Biomarkers, Tumor / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D053554:Keratin-20 / Q000096:biosynthesis; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D017350:N-Acetylgalactosaminyltransferases / Q000096:biosynthesis; D009363:Neoplasm Proteins / Q000096:biosynthesis; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000276:immunology*; D011379:Prognosis; D019859:Proto-Oncogene Proteins c-met / Q000096:biosynthesis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D000097763:Polypeptide N-acetylgalactosaminyltransferase
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053554:Keratin-20; D017350:N-Acetylgalactosaminyltransferases; D009363:Neoplasm Proteins; D019859:Proto-Oncogene Proteins c-met; D000097763:Polypeptide N-acetylgalactosaminyltransferase; C072013:MAGEA3 protein, human