Investigation of free cancer cells in peripheral blood using CEA mRNA expression in perioperative colorectal cancer patients.
Investigation of free cancer cells in peripheral blood using CEA mRNA expression in perioperative colorectal cancer patients.
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DOI：
10.3892/mco.2013.109
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发表时间：
2013-07
影响因子：
1.2
通讯作者：
Sakamoto K
中科院分区：
文献类型：
--
作者：
Nagayasu K;Komiyama H;Ishiyama S;Ogura D;Takahashi R;Tashiro Y;Niwa K;Sugimoto K;Kojima Y;Goto M;Tomiki Y;Niwa S;Sakamoto K
本研究的目的是评估腹腔镜手术（Lap）对结直肠癌患者循环游离肿瘤细胞的影响。在这项研究中，我们选择癌胚抗原（CEA）mRNA表达在外周血中作为循环肿瘤细胞的标志物，并比较这一标志物之间的腹腔镜手术和开放式结肠切除术（OC），调查由于手术方法的差异。2008年6月至2011年2月，共有50例孤立性结直肠癌患者在我科接受了根治性手术。患者分为OC组和Lap组（各25例）。在手术前、手术后即刻和手术后1、3和7天采集外周血后提取总RNA。采用逆转录聚合酶链反应（RT-PCR）检测癌胚抗原（CEA）mRNA，并分析外周血CEA mRNA阳性率与手术所见及临床病理特征的关系。术后即刻外周血CEA mRNA阳性率较术前显著升高（P=0.001），但随时间推移呈下降趋势。在术后第1天后的任何采血时间点均未观察到显著差异。与术前相比，OC组术后即刻的阳性率显著增加（P=0.004）。然而，腹腔镜组术前和术后即刻的发生率无显著差异。术后将患者分为外周血CEA mRNA阳性组和阴性组（分别为术后阳性组和阴性组），比较两组患者的临床病理特征。在低位直肠癌患者和术中大量失血患者中，两组之间存在显著差异（分别为P=0.001和P=0.01）。总之，在结直肠癌患者中，接受OC和Lap手术的患者之间围手术期外周血CEA mRNA阳性率或其短期变化无显著差异。有人认为，Lap在游离癌细胞方面相当于OC。
The aim of this study was to evaluate the impact of laparoscopic surgery (Lap) on circulating free tumor cells in colorectal cancer patients. In this study, we selected carcinoembryonic antigen (CEA) mRNA expression in peripheral blood as the marker of the circulating tumor cells and compared this marker between Lap and open colectomy (OC), to investigate differences due to surgical approach. A total of 50 patients underwent curative surgery for solitary colorectal cancer at our department, between June, 2008 and February, 2011. The patients were divided into OC and Lap groups (25 patients each). Total RNA was extracted subsequent to peripheral blood collection prior to surgery, immediately following surgery and 1, 3 and 7 days after surgery. CEA mRNA was detected with reverse transcription polymerase chain reaction (RT-PCR) and the association between peripheral blood CEA mRNA-positive rate, surgical findings and clinicopathological characteristics was investigated. The peripheral blood CEA mRNA-positive rate was significantly increased immediately after surgery, compared to the preoperative rate (P=0.001), but decreased over time. No significant differences were observed at any blood-sampling time point after postoperative day 1. The positive rate was significantly increased in the OC group immediately after surgery, compared to the preoperative rate (P=0.004). However, there were no significant differences between the rates prior to and immediately after surgery in the Lap group. The patients were then divided into those who were peripheral blood CEA mRNA-positive and -negative after surgery (postoperative positive and negative groups, respectively) and the clinicopathological characteristics were compared. Significant differences were identified between the groups in lower rectal cancer patients and patients with a large intraoperative blood loss (P=0.001 and P=0.01, respectively). In conclusion, in colorectal cancer patients, there were no significant differences in the perioperative peripheral blood CEA mRNA-positive rate or its short-term changes between patients undergoing OC and Lap surgery. It was suggested that Lap is equivalent to OC with regard to free cancer cells.