Usefulness and clinical significance of quantitative real-time RT-PCR to detect isolated tumor cells in the peripheral blood and tumor drainage blood of patients with colorectal cancer.
Usefulness and clinical significance of quantitative real-time RT-PCR to detect isolated tumor cells in the peripheral blood and tumor drainage blood of patients with colorectal cancer.
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DOI：
10.3892/ijo.28.2.297
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发表时间：
2006-02
影响因子：
5.2
通讯作者：
H. Iinuma;K. Okinaga;H. Egami;K. Mimori;N. Hayashi;K. Nishida;M. Adachi;M. Mori;M. Sasako
中科院分区：
文献类型：
--
作者：
H. Iinuma;K. Okinaga;H. Egami;K. Mimori;N. Hayashi;K. Nishida;M. Adachi;M. Mori;M. Sasako
结直肠癌患者血液中循环的分离肿瘤细胞（ITC）的临床意义尚不清楚。在这项研究中，我们使用定量实时逆转录聚合酶链反应（RT-PCR）测定研究了血液中表达癌胚抗原（CEA）和/或细胞角蛋白20（CK20）转录本的ITC的存在与临床病理学结果和预后之间的关系。我们研究了 167 名结直肠癌患者的外周血和肿瘤引流血。实时定量RT-PCR检测能够在3x10(6)个外周血单核细胞中检测到一个肿瘤细胞。应用截止值，10.2%（17/167）的患者术前外周血样本和34.1%（57/167）的患者肿瘤引流血样本中检测到CEA和/或CK20（CEA/CK20）。血液CEA/CK20与临床病理因素的关系中，标志基因的阳性与侵犯深度、静脉侵犯、淋巴结转移、肝转移或分期存在显着相关性。 CEA/CK20阳性外周血或肿瘤引流血患者的无病生存期和总生存期显着短于标志基因阴性患者。肿瘤引流血中的CEA/CK20转录物是无病生存和总生存预后的独立因素。这些结果表明，通过实时RT-PCR检测肿瘤引流血中的CEA/CK20 mRNA对结直肠癌患者具有预后价值。需要大规模、长期的临床研究来证实外周血中ITC基因检测的预后价值。
The clinical significance of isolated tumor cells (ITC) circulating in the blood of patients with colorectal cancer is unclear. In this study, we investigated the relationship between the presence of ITC that express carcinoembryonic antigen (CEA) and/or cytokeratin 20 (CK20) transcripts in the blood and the clinicopathological findings and prognosis using the quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. We studied peripheral blood and tumor drainage blood from 167 patients with colorectal cancer. Quantitative real-time RT-PCR assay was able to detect one tumor cell in 3x10(6) peripheral blood mononuclear cells. Applying a cut-off value, CEA and/or CK20 (CEA/CK20) were detected in 10.2% (17/167) of the patients' preoperative peripheral blood samples and 34.1% (57/167) of the patients' tumor drainage blood samples. In the relationship between the CEA/CK20 of the blood and the clinicopathological factors, a significant correlation was demonstrated between the positivity of marker genes and the depth of invasion, venous invasion, lymph node metastasis, liver metastasis or stage. The disease-free and overall survival of patients with CEA/CK20-positive peripheral or tumor drainage blood was significantly shorter than that of marker gene-negative patients. CEA/CK20 transcripts in tumor drainage blood were independent factors for prognosis in disease-free survival and overall survival. These results suggest that detecting CEA/CK20 mRNA in tumor drainage blood by real-time RT-PCR has prognostic value in patients with colorectal cancer. Large scale and long-term clinical studies are needed to confirm the prognostic value of genetically detecting ITC in the peripheral blood.