title: Cytokeratin 20 positive cells in blood of colorectal cancer patients as an unfavorable prognostic marker.
abstract: OBJECTIVE
  Cytokeratin 20 (CK20) is one of the most investigated markers for the detection of circulating colorectal cancer (CRC) cells by reverse transcription polymerase chain reaction (RT-PCR). The aim of this study was to evaluate prognostic value of RT-PCR detection of circulating CRC cells using CK20 as a marker, and to compare the value of preoperative and postoperative blood sample analysis for that purpose.
  
  
  METHODS
  Ribonucleic acid (RNA) was isolated from mononuclear cell fraction of blood samples taken from 95 CRC patients before and after tumor resection and from 23 healthy volunteers and assayed by real-time RT-PCR for CK20 expression.
  
  
  RESULTS
  In patients positive for CK20 postoperatively both progression-free survival (PFS) and overall survival were significantly shorter than in patients negative for CK20 postoperatively, while the difference between patients positive and negative for CK20 preoperatively was not statistically significant in terms of neither PFS nor overall survival.
  
  
  CONCLUSIONS
  Our results have shown prognostic value of circulating cancer cells detected in postoperative blood samples from CRC patients using CK20 as marker for RT-PCR, which has potential implications for treatment of these patients. In clinical practice, CK20 expression profile could be a factor in weighting treatment options in CRC patients. In cases where multiple treatment options are possible, patients with positive postoperative CK20 expression could be candidates to receive more aggressive treatment.
authors.affiliation: a Department of Oncology and Nuclear Medicine , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Kust
authors.affiliation: a Department of Oncology and Nuclear Medicine , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Šamija
authors.affiliation: b Department of Surgical Oncology , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Iva
authors.initials: I
authors.lastname: Kirac
authors.affiliation: a Department of Oncology and Nuclear Medicine , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Jasna
authors.initials: J
authors.lastname: Radić
authors.affiliation: c Department of Surgery , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Dujo
authors.initials: D
authors.lastname: Kovačević
authors.affiliation: a Department of Oncology and Nuclear Medicine , University Hospital Center "Sestre Milosrdnice" , Zagreb , Croatia.
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Kusić
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053554:Keratin-20 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000737:chemistry; D011379:Prognosis; D012372:ROC Curve
chemical_list: D014408:Biomarkers, Tumor; D053554:Keratin-20
keywords: Biological tumor markers; Circulating neoplastic cells; Colorectal cancer; Cytokeratin-20; Reverse transcription polymerase chain reaction