Department of Surgery, Teikyo University School of Medicine, Tokyo 173-0003, Japan.
Oncol Rep. 2012 Apr;27(4):947-53. doi: 10.3892/or.2012.1649. Epub 2012 Jan 19.
The clinical significance of circulating tumor cells (CTCs) including cancer stem cells (CSCs) (CTC/CSC) in the tumor drainage vein blood of patients with colorectal cancer (CRC) is unclear. In this study, we investigated the prognostic value of CTC/CSC that express carcinoembryonic antigen (CEA) cytokeratin 19 (CK19), CK20 and/or CD133 (CEA/CK/CD133) mRNA in the tumor drainage blood of CRC patients with Dukes' stage B and C. We examined tumor drainage blood from 197 patients with Dukes' stage B and C CRC. CTCs that expressed CEA, CK19, CK20 and CD133 mRNA were detected using the quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. Each mRNA level was normalized with GAPDH mRNA levels. In the relationship between the expression of CEA/CK/CD133 in the tumor drainage blood and clinicopathological factors, a significant correlation was observed between CEA/CK/CD133 expression and Dukes' stage (p<0.041). In CRC patients with Dukes' stage B and C, disease-free (DFS) and overall survival (OS) of patients with CEA/CK/CD133 positive in the tumor drainage blood were significantly worse than that of marker gene negative patients. In contrast, in patients with Dukes' stage A, no significant differences were shown between these groups. By Cox progression analysis, it was shown that CEA/CK/CD133 mRNA in tumor drainage blood was an independent prognostic factor for DFS and OS in patients with Dukes' stage B and C. These results suggest that detecting CEA/CK/CD133 mRNA in tumor drainage blood by the real-time RT-PCR method would have a prognostic value in CRC patients with Dukes' stage B and C.
循环肿瘤细胞（CTC）包括结直肠癌（CRC）患者肿瘤引流静脉血中的肿瘤干细胞（CSC）（CTC/CSC）的临床意义尚不清楚。在这项研究中，我们研究了 Dukes'B 和 C 期 CRC 患者肿瘤引流血中表达癌胚抗原（CEA）细胞角蛋白 19（CK19）、CK20 和/或 CD133（CEA/CK/CD133）mRNA 的 CTC/CSC 的预后价值。我们检查了 197 例 Dukes'B 和 C 期 CRC 患者的肿瘤引流血。使用定量实时逆转录-聚合酶链反应（RT-PCR）检测表达 CEA、CK19、CK20 和 CD133 mRNA 的 CTC。每个 mRNA 水平均与 GAPDH mRNA 水平归一化。在肿瘤引流血中 CEA/CK/CD133 的表达与临床病理因素之间的关系中，CEA/CK/CD133 表达与 Dukes'分期之间存在显著相关性（p<0.041）。在 Dukes'B 和 C 期 CRC 患者中，肿瘤引流血中 CEA/CK/CD133 阳性患者的无病生存期（DFS）和总生存期（OS）明显差于标志物基因阴性患者。相比之下，在 Dukes'期 A 的患者中，这些组之间没有显示出显著差异。通过 Cox 进展分析表明，肿瘤引流血中的 CEA/CK/CD133 mRNA 是 Dukes'B 和 C 期患者 DFS 和 OS 的独立预后因素。这些结果表明，通过实时 RT-PCR 方法检测肿瘤引流血中的 CEA/CK/CD133 mRNA 对 Dukes'B 和 C 期 CRC 患者具有预后价值。
