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Prophylactic intra-hepatic arterial infusion chemotherapy for patients with curatively resected colon cancer based on the results of the detection of circulating cancer cells in blood

基于血液中循环癌细胞检测结果对结肠癌根治性切除患者进行预防性肝动脉灌注化疗

基本信息

批准号：
14571231
负责人：
SADAHIRO Sotaro
金额：
$ 2.11万
依托单位：
Tokai University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2004
项目状态：
已结题

项目摘要

We reported that prophylactic intra-hepatic arterial infusion (HAI) of 5-FU for three weeks prohibited liver metastasis in patients with stage II or stage III colon cancer. We would like to indicate this prophylactic HAI chemotherapy for high risk patients of liver metastasis following curative resection. Although many investigations have been made to examine the detection of circulating cancer cells in blood as a possible prognostic indicator, the results vary among studies.We first examined CEA mRNA expression in circulating blood taken immediately after laparotomy in 100 patients. The median follow up period was 59 months (range : 49-74 months). The results did not correlate with the recurrence of colorectal cancer. Fidler et al. reported that cancer cells injected into the tail veins in mice were not detected in blood seven days after injection. Therefore, we speculated that the detection of cancer cells in peripheral blood taken at 7-10 days after curative resection of colorectal cancer may correlate with recurrence and may be a reliable prognostic indicator.Then we took blood samples seven to ten days after curative resection of stage II or stage III colorectal cancer in 201 patients. The median follow-up period was 38 months (range : 22-56 months). Recurrence was observed in 48 (24%) out of 201 patients. CEA mRNA expression in peripheral blood was detected in 45 patients (22%). Recurrence rate was 38% (17/45) in the CEA mRNA positive and 20% (31/156) in the CEA mRNA negative group (P = 0.02). Disease-free and recurrence-free survival rates were both significantly higher in the CEA mRNA negative than in the CEA mRNA positive group (P = 0.03 and 0.03, respectively).Based on the above results, prophylactic HAI chemotherapy for these CEA mRNA positive patients has been under going.

我们报道了预防性肝内动脉灌注（HAI）5-FU三周可阻止II期或III期结肠癌患者的肝转移。我们希望指出这种预防性HAI化疗用于根治性切除术后肝转移的高危患者。虽然已经进行了许多调查，以检查血液中的循环癌细胞的检测作为一个可能的预后指标，结果各不相同的研究。我们首先检查了100例剖腹手术后立即采取的循环血中CEA mRNA的表达。中位随访期为59个月（范围：49-74个月）。结果与结直肠癌复发无关。Fidler等人报告称，注射到小鼠尾静脉中的癌细胞在注射后7天在血液中未检测到。因此，我们推测，在大肠癌根治性切除术后7-10天采集的外周血中癌细胞的检测可能与复发相关，并且可能是可靠的预后指标。然后，我们在201例II期或III期大肠癌根治性切除术后7 - 10天采集了血液样本。中位随访期为38个月（范围：22-56个月）。在201例患者中观察到48例（24%）复发。45例（22%）患者外周血CEA mRNA阳性。CEA mRNA阳性组复发率为38%（17/45），阴性组复发率为20%（31/156），两组比较差异有显著性（P = 0.02）。CEA mRNA阴性组的无病生存率和无复发生存率均显著高于CEA mRNA阳性组（P分别为0.03和0.03）。