engleski

Detection of circulating cancer cells in peripheral blood samples obtained before and during surgery for colorectal cancer using cytokeratin-20 as a marker

Detection of circulating cancer cells by RT-PCR has been studied as a potential prognostic marker in colorectal cancer patients but so far with conflicting results regarding its specificity and prognostic value. In this study cytokeratin-20 (CK20) was evaluated as a marker for circulating colorectal cancer cells detection by RT-PCR and influence of surgical tumor resection on the presence of circulating colorectal cancer cells was analyzed. From 45 colorectal cancer patients peripheral venous blood samples were obtained before and during primary tumor dissection. Blood samples from 21 healthy volunteers were analyzed as controls. RNA was isolated from mononuclear cell fraction of the blood and assayed by RT-PCR for the expression of CK20. All samples from 21 healthy volunteers were negative for CK20 expression. Out of 45 colorectal cancer patients, 9 (20%) were positive for CK20 expression before surgery, and 10 (22.2%) were positive during surgery. Four patients (8.8%) were positive for CK20 both before and during surgery, 30 patients (66.7%) were negative both before and during surgery, 5 patients (11.1%) were positive before but negative during surgery, and 6 patients (13.3%) were negative before but positive during surgery. A statistically significant trend of increase in the proportion of patients positive for CK20 with increasing stage of the disease was observed for preoperative (p=0.034), but not for postoperative blood samples (p=0.099) (Chi-square test for trend). This study confirms the value of CK20 as a specific marker for detection of circulating colorectal cancer cells and association with clinical stage in preoperative blood samples indicates potential prognostic value of CK20-specific circulating cancer cells detection in patients with colorectal cancer. Results of this study indicate that surgical tumor resection can both reduce and induce the presence of circulating colorectal cancer cells.

cytokeratin-20; colorectal cancer; circulating tumor cells

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