Číslo abstraktu: 045
Autoři: MUDr. Josef Srovnal, Ph.D.; doc. MUDr. Kamil Vysloužil, CSc.; Mgr. Sylwia Jančík (Wieczek); Mgr. Lenka Radová, Ph.D.; prof. MUDr. Miloslav Duda, DrSc.; MUDr.Mgr. Pavel Skalický, Ph.D.; MUDr. Ivo Klementa, Ph.D.; MUDr. Lubomír Starý, Ph.D.; MUDr. Karel Cwiertka, Ph.D.; MUDr. Jana Strážnická; MUDr. Vlastislav Šrámek, PhD; prof. MUDr. Bohuslav Melichar, Ph.D.; doc. MUDr. Marián Hajdúch, Ph.D.
We tested the hypothesis that the presence of circulating tumor cells (CTCs) is a negative prognostic factor in patients with stage I-III colorectal cancer (CRC).
Patients and methods
This was a prospective study to test for the presence of CTCs in peripheral blood and bone marrow in 182 colorectal cancer patients at the time of surgery and one month after surgery using real-time RT-PCR for carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20).
Overall, 24 of 147 (16.3%) stage I-III CRC patients developed recurrence/metastasis postoperatively in a mean follow-up period of 22.9 months. There was no correlation between CTCs and conventional clinical pathological features. In total, 51.7% of patients were CTC positive detected in peripheral blood and/or bone marrow at the time of surgery using CEA and/or CK20 and 47% of patients were CTC positive one month after surgery. At surgery, CTC positive patients measured as CEA mRNA copy number in peripheral blood showed significantly poorer disease-free survival (DFS) (p = 0.05). One month after surgery, both increased above threshold CEA and/or CK20 mRNA levels in bone marrow and CK20 mRNA level in blood correlated with shorter DFS (p = 0.005, resp. p = 0.0035). In addition, systemic increase in CEA gene expression, even if the values remained below cut-off threshold, also correlated with poorer DFS (p = 0.005).
Detection of CTCs at surgery and/or one month after surgery is an independent negative prognostic factor for relapsing-free survival in stage I-III colorectal cancer.
Acknowledgments of research support
This study was supported by grants awarded by the Czech Ministry of School and Education (MSM 6198959216), Czech Ministry of Health (IGA MZCR NR/7804-5 and IGA MZCR NR/9076) and the EU infrastructure support CZ.1.05/2.1.00/01.0030.
Datum přednesení příspěvku: 28. 1. 2011