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Prognostic value of cytokeratin-20 positive cells detected by real-time RT-PCR in preoperative blood samples from colorectal cancer patients

Cytokeratin 20 (CK20) was investigated in this study as a marker for the preoperative detection of circulating colorectal cancer cells by real-time reverse transcription polymerase chain reaction (RT-PCR).The aim of the study was to determine the prognostic value of preoperative CK20 in patients with colorectal cancer. Peripheral blood samples from 95 colorectal cancer patients in all stages of the disease were analyzed by real-time RT-PCR for the expression of CK20. A blood sample for analysis was obtained from each patient before tumor resection. Out of 95 colorectal cancer patients, 69 (72, 6%) were positive for CK20 preoperatively. Median follow-up for patients was 50 months (range 0 - 60 months). Progression-free survival was not significantly different between patients positive for CK20 and patients negative for CK20 (p=0, 12, log-rank test). Overall survival was also not significantly different between patients positive for CK20 and patients negative for CK20 (p=0, 24, log-rank test). In univariate regression analysis CK20 value was not a significant predictor for neither progression-free survival (hazard ratio=0, 42 ; 95%CI, 0, 23-1, 19 ; p=0, 12) nor overall survival (hazard ratio=0, 61 ; 95%CI, 0, 27-1, 40 ; p=0, 24). The only significant independent prognostic factor for either progression-free survival or overall survival selected with multivariate analysis was AJCC stage of disease. Our results suggest that preoperative analysis of CK20 expression by real-time RT-PCR as a marker for the detection of circulating cancer cells has no prognostic value in patients with colorectal cancer.

colorectal cancer; circulating cancer cells; cytokeratin-20; real-time RT-PCR

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