Clinical application of detection of isolated tumor cells with cancer stem-like cells as prognostic tool in colorectal cancer patient

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In this study, we aimed to clarify a clinical significance of circulating tumor cell(CTC) in peripheral blood(PB) and tumor drainage vein blood(TDVB), and isolated tumor cells(ITC) in peritoneal washings of colorectal cancer(CRC) patients. We selected the multiple genetic marker include the cancer associate marker(CEA), epithelial markers(cytokeratin : CK19, CK20), and cancer stem cell-like cell marker(CD133). In this study, overall survival(OS) and disease-free survival(DFS) of Dukes' stage B and C patients who were positive for CEA, CK and/or CD133 in PB or TDVB were significantly worse than those of patients who were negative for these markers. It was demonstrated that multimarker was a significant prognostic factor for OS and DFS in patients with Dukes stage B and C cancer(JCO 2011, Oncol Rep 2012). Furthermore, we examined the prognostic value of ITC in peritoneal washings from CRC patients after curative resection using multiple molecular markers CEA/CK/CD133.In this study, OS and peritoneal recurrence-free survival rates in CEA, CK and/or CD133 mRNA-positive patients were significantly lower than those of marker gene-negative patients. It was demonstrated that CEA, CK and CD133 mRNAs in peritoneal washings were independent prognostic factors for OS and DFS(Oncology 2010).