Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Asian J Surg. 2018 Jul;41(4):321-327. doi: 10.1016/j.asjsur.2017.01.004. Epub 2017 Mar 11.
BACKGROUND/OBJECTIVE: Positive carcinoembryonic antigen (CEA) messenger RNA (mRNA) in peritoneal lavage is associated with poor prognosis in patients with colon cancer. However, there are no reports about rectal cancer. Therefore we aimed to evaluate the frequency of positive CEA mRNA in peritoneal lavage and the significance of CEA mRNA in patients with low rectal cancer.
A total of 55 patients with low rectal cancer who received curative surgical resection were enrolled. CEA mRNA in peritoneal lavage was measured using the transcription-reverse transcription concerted method, a quantitative RNA amplification method. The correlation between CEA mRNA and overall and peritoneal recurrence-free survival was evaluated.
Among 55 patients, 6 (10.9%) had positive CEA mRNA in peritoneal lavage. Patients with positive CEA mRNA resulted in significantly higher recurrence rate than those with negative CEA mRNA (p=0.007). Similarly, the local recurrence rate was significantly higher in the positive CEA mRNA group than in the negative CEA mRNA group (p=0.0009). Lymph node metastasis and positive CEA mRNA were independent risk factors for overall and local recurrence.
Positive CEA mRNA in low rectal cancer is a factor that predisposes patients to a high risk for overall recurrence, especially for local recurrence.
背景/目的：腹腔冲洗液中阳性癌胚抗原（CEA）信使 RNA（mRNA）与结肠癌患者的预后不良相关。然而，目前尚无关于直肠癌的报道。因此，我们旨在评估低位直肠癌患者腹腔冲洗液中 CEA mRNA 的阳性率及其意义。
共纳入 55 例接受根治性手术切除的低位直肠癌患者。采用转录-逆转录协同方法（一种定量 RNA 扩增方法）检测腹腔冲洗液中的 CEA mRNA。评估 CEA mRNA 与总生存和腹膜无复发生存之间的相关性。
在 55 例患者中，有 6 例（10.9%）腹腔冲洗液中 CEA mRNA 阳性。CEA mRNA 阳性患者的复发率明显高于 CEA mRNA 阴性患者（p=0.007）。同样，CEA mRNA 阳性组的局部复发率明显高于 CEA mRNA 阴性组（p=0.0009）。淋巴结转移和 CEA mRNA 阳性是总复发和局部复发的独立危险因素。
低位直肠癌中 CEA mRNA 阳性是患者总体复发风险升高的一个因素，尤其是局部复发风险升高的一个因素。
