The influence of opioid analgesia for the presence of circulating tumor cells in colorectal and pancreatic cancer

Konference: 2015 XI. Dny diagnostické, prediktivní a experimentální onkologie

Kategorie: Gastrointestinální nádory; Kolorektální karcinom

Téma: Molekulární mechanismy a biomarkery II

Číslo abstraktu: 027

Autoři: Bc. Monika Vahalíková; MUDr. Josef Srovnal, Ph.D.; MUDr. Emil Berta, Ph.D.; MUDr. Petr Prášil; Mgr. Andrea Prokopová; Mgr. Jana Vrbková, Ph.D.; doc. MUDr. Marián Hajdúch, Ph.D.


Pancreatic cancer and colorectal cancer (CRC) is the most common cause of death from cancer in the world. Both cancers are also known high incidence of metastasis. The aim of the study was to analyze the effect of the opioid analgesic to the amount of circulating tumor cells (CTC) in patients with colorectal cancer and pancreatic cancer after surgical removal of the tumor and the influence of administered analgesia to the length of the disease-free survival (DFS) and the overall (OS) survival. Additionally, we focused on the difference in the expression of various opioid receptors in samples of tumor tissues of examined patients.


Presence of the CTC/DTC in blood and bone marrow was investigated in 121 patients with CRC in stage I-III after ratered analgesic was compared with the presence of CTC/ DTC detected using real-time PCR quantification of epithelial genes CEA and CK20 at surgery and one month after surgery and with DFS and OS of patients. Evaluated was also the influence of other perioperative factors (eg. The quantity of blood transfusions). In the same way was evaluated the data for pancreatic cancer using biomarkers CEA, EGFR and hTERT for detection of CTC/ DTC in the blood and bone marrow. Further, was investigated the κ and opioid growth factor receptor in tumor tissue samples.

Results and conclusions

One month after surgery was in patients with CRC after administration of MA using realtime PCR detected higher levels of CK20 in peripheral blood (p <0.045) and bone marrow (p <0.065). Furthermore, MA was associated with significantly shorter DFS and was a negative prognostic factor in patients negative for CEA and CK20 in portal blood (p <0.019) and in patients positive for CEA (p <0.028) and CK20 (p <0.015). Preliminary data obtained from the analysis of samples of pancreatic cancer patients show the opposite influence on the presence of CTCs and disease progression. MA in the case of pancreatic cancer behaves as a protective factor. It may be caused by the expression of the different subtypes of the opioid receptors for the said diagnosis, because in pancreatic cancer, we found higher expression of the opioid receptor μ than in colorectal cancer.


Analgesics based on morphine but not piritramide, increase presence of CTC/DTC and shorten the DFS for patients with CRC in stage I-III after surgical removal of the tumor. In the case of pancreatic cancer pilot data show that MA behaves as a protective factor.

The work was supported by grants: IGA LF UP 2015_010 a TAČR TE02000058

Datum přednesení příspěvku: 3. 12. 2015