Prognostic relevance of occult nodal micrometastases and circulating tumor cells in colorectal cancer in a prospective multicenter trial.
Prognostic relevance of occult nodal micrometastases and circulating tumor cells in colorectal cancer in a prospective multicenter trial.
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一项前瞻性多中心试验中结直肠癌隐匿性淋巴结微转移和循环肿瘤细胞的预后相关性。
DOI：
10.1158/1078-0432.ccr-08-0290
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发表时间：
2008-11-15
影响因子：
11.5
通讯作者：
Hoon, Dave S. B.
中科院分区：
文献类型：
--
作者：
Koyanagi, Kazuo;Bilchik, Anton J.;Saha, Sukamal;Turner, Roderick R.;Wiese, David;McCarter, Martin;Shen, Perry;Deacon, Linda;Elashoff, David;Hoon, Dave S. B.
通过多标志物定量实时 RT-PCR (qRT) 检测的淋巴结微转移和循环肿瘤细胞 (CTC) 可能对结直肠癌 (CRC) 患者的预后具有重要意义。在一项 CRC SLN 定位前瞻性多中心试验中，对 67 名患者的石蜡包埋前哨淋巴结 (SLN) 和其中 34 名患者的血液进行了评估。通过苏木精和伊红染色 (H&E) 和细胞角蛋白免疫组织化学 (CK-IHC) 检查前哨淋巴结。通过四标记 qRT 检测（c-MET、MAGE-A3、GalNAc-T、CK20）检查 SLN 和血液； qRT 结果与疾病阶段和结果相关。在复发的 H&E SLN 阴性患者中，CK-IHC 和 qRT 分别检测到 30% 和 60% 的患者存在转移。 DFS 因多标志物 qRT 抢先 SLN 而存在显着差异 (p=0.014)。血液 CTC 的 qRT 分析与总生存期相关 (p=0.040)。对前哨淋巴结和血液样本中微转移的分子评估可能有助于识别患有复发性结直肠癌的高危患者，这些患者可以从辅助治疗中受益。
Nodal micrometastasis and circulating tumor cells (CTC) detected by multimarker quantitative real-time RT-PCR (qRT) may have prognostic importance in patients with colorectal cancer (CRC). Paraffin-embedded sentinel lymph nodes (SLNs) from 67 patients and blood from 34 of these patients was evaluated in a prospective multicenter trial of SLN mapping in CRC. SLNs were examined by hematoxylin and eosin staining (H&E) and cytokeratin immunohistochemistry (CK-IHC). Both SLNs and blood were examined by a four-marker qRT assay (c-MET, MAGE-A3, GalNAc-T, CK20); qRT results were correlated with disease stage and outcome. In H&E SLN negative patients that recurred, CK-IHC and qRT detected metastasis in 30% and 60% of patients, respectively. DFS differed significantly by multimarker qRT upstaged SLN (p=0.014). qRT analysis of blood for CTC correlated with overall survival (p=0.040). Molecular assessment for micrometastasis in SLN and blood specimens may help identify patients at high-risk for recurrent CRC, who could benefit from adjuvant therapy.