title: Disseminated tumour cells as a prognostic biomarker in colorectal cancer.
abstract: BACKGROUND
  The study was performed to determine detection rate and prognostic relevance of disseminated tumour cells (DTC) in patients receiving curatively intended surgery for colorectal cancer (CRC).
  
  
  METHODS
  The study population consisted of 235 patients with CRC prospectively recruited from five hospitals in the Oslo region. Bone marrow (BM) aspirates were collected at the time of surgery and the presence of DTC was determined by two immunological methods; immunomagnetic selection (using an anti-EpCAM antibody) and immunocytochemistry (using a pan-cytokeratin antibody). Associations between the presence of DTC and metastasis-free, disease-specific and overall survival were analysed using univariate and multivariate methods.
  
  
  RESULTS
  Disseminated tumour cells were detected in 41 (17%) and 28 (12%) of the 235 examined BM samples by immunomagnetic selection and immunocytochemistry, respectively, with only five samples being positive with both methods. The presence of DTC was associated with adverse outcome (metastasis-free, disease-specific and overall survival) in univariate and multivariate analyses.
  
  
  CONCLUSIONS
  The presence of DTC was associated with adverse prognosis in this cohort of patients curatively resected for CRC, suggesting that DTC detection still holds promise as a biomarker in CRC.
authors: Department of Tumor Biology, Norwegian Radium Hospital, Oslo University Hospital, Oslo 0424, Norway. kjersti.flatmark@rr-research.no
authors: K
authors: K
authors: Flatmark
authors: E
authors: E
authors: Borgen
authors: J M
authors: JM
authors: Nesland
authors: H
authors: H
authors: Rasmussen
authors: H-O
authors: HO
authors: Johannessen
authors: I
authors: I
authors: Bukholm
authors: R
authors: R
authors: Rosales
authors: L
authors: L
authors: Hårklau
authors: H J
authors: HJ
authors: Jacobsen
authors: B
authors: B
authors: Sandstad
authors: K
authors: K
authors: Boye
authors: Ø
authors: Ø
authors: Fodstad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000951:Antigens, Neoplasm / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology*; D015815:Cell Adhesion Molecules / Q000032:analysis; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018189:Immunomagnetic Separation; D053208:Kaplan-Meier Estimate; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009664:Norway; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000951:Antigens, Neoplasm; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule; D007633:Keratins