Detection of carcinoembryonic antigen messenger RNA in blood using quantitative real-time reverse transcriptase-polymerase chain reaction to predict recurrence of gastric adenocarcinoma.
BACKGROUND
The existence of circulating tumor cells (CTCs) in peripheral blood as an indicator of tumor recurrence has not been clearly established, particularly for gastric cancer patients. We conducted a retrospective analysis of the relationship between CTCs in peripheral blood at initial diagnosis and clinicopathologic findings in patients with gastric carcinoma.


METHODS
Blood samples were obtained from 123 gastric carcinoma patients at initial diagnosis. mRNA was extracted and amplified for carcinoembryonic antigen (CEA) mRNA detection using real-time RT-PCR. Periodic 3-month follow-up examinations included serum CEA measurements and imaging.


RESULTS
The minimum threshold for corrected CEA mRNA score [(CEA mRNA/GAPDH mRNA) × 106] was set at 100. Forty-five of 123 patients (36.6%) were positive for CEA mRNA expression. CEA mRNA expression significantly correlated with T stage and postoperative recurrence status (P = 0.001). Recurrent disease was found in 44 of 123 cases (35.8%), and 25 of these (56.8%) were positive for CEA mRNA. Of these patients, CEA mRNA was more sensitive than serum CEA in indicating recurrence. Three-year disease-free survival of patients positive for CEA mRNA was significantly poorer than of patients negative for CEA mRNA (P < 0.001). Only histological grade and CEA mRNA positivity were independent factors for disease-free survival using multivariate analysis.


CONCLUSIONS
CEA mRNA copy number in peripheral blood at initial diagnosis was significantly associated with disease recurrence in gastric adenocarcinoma patients. Real-time RT-PCR detection of CEA mRNA levels at initial diagnosis appears to be a promising predictor for disease recurrence in gastric adenocarcinoma patients.
State Key Laboratory of Oncology in South China, Guangzhou 510060, China.
Miao-Zhen
MZ
Qiu
Zhuang-Hua
ZH
Li
Zhi-Wei
ZW
Zhou
Yu-Hong
YH
Li
Zhi-Qiang
ZQ
Wang
Feng-Hua
FH
Wang
Peng
P
Huang
Fahad
F
Aziz
Dao-Yuan
DY
Wang
Rui-Hua
RH
Xu
D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology*; D000328:Adult; D000368:Aged; D001483:Base Sequence; D002272:Carcinoembryonic Antigen / Q000235:genetics*; D017931:DNA Primers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000097:blood*; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D013274:Stomach Neoplasms / Q000276:immunology / Q000473:pathology*
D002272:Carcinoembryonic Antigen; D017931:DNA Primers; D012333:RNA, Messenger