Mori M, Mimori K, Ueo H, Karimine N, Barnard G F, Sugimachi K, Akiyoshi T
Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan.
Int J Cancer. 1996 Dec 11;68(6):739-43. doi: 10.1002/(SICI)1097-0215(19961211)68:6<739::AID-IJC8>3.0.CO;2-4.
Detection of the mRNA of selected genes by reverse transcriptase-polymerase chain reaction (RT-PCR) is a sensitive and powerful tool for detecting cancer cells in bone-marrow or peripheral-blood samples. In this study, we determined whether carcinoembryonic antigen (CEA) mRNA is detectable in the peripheral blood of patients with gastrointestinal or breast cancer. In addition, we studied selected patients undergoing surgical procedures to assess whether tumor manipulation during operation enhances cancer-cell dissemination. Peripheral blood from 55 patients with gastrointestinal or breast cancer and from 22 control cases was analysed for CEA mRNA using RT-PCR. For 15 selected cases undergoing curative surgery for cancer, samples were also obtained during and after surgery. The lower limit of detection was 1 to 10 CEA-positive cells diluted among 1 x 10(7) blood mononuclear cells. The test was positive for 20 of the 55 patients with cancer (36%). None of the 22 control samples were positive. An increase in positivity was observed with increasing stage of disease; however, even some patients with early-stage cancer showed positive results. In addition, CEA mRNA could be detected in the peripheral blood during operation in 3 of 13 patients whose pre-operative CEA mRNA in the peripheral blood had been negative. These findings suggest that, (1) RT-PCR amplification of CEA mRNA is an efficient means of detecting circulating solid cancer cells in the peripheral blood, although long-term clinical studies should be done to evaluate its usefulness; (2) not only breast cancer but also gastrointestinal cancer might be better regarded as a systemic disease even in early stages of carcinoma; and (3) surgical manipulation can provoke cancer-cell dissemination.
通过逆转录聚合酶链反应（RT-PCR）检测特定基因的mRNA是检测骨髓或外周血样本中癌细胞的一种灵敏且强大的工具。在本研究中，我们确定胃肠道或乳腺癌患者外周血中是否可检测到癌胚抗原（CEA）mRNA。此外，我们研究了部分接受外科手术的患者，以评估手术过程中的肿瘤操作是否会促进癌细胞播散。使用RT-PCR分析了55例胃肠道或乳腺癌患者及22例对照者的外周血CEA mRNA。对于15例接受癌症根治性手术的特定病例，还在手术期间及术后采集了样本。检测下限为在1×10⁷个血液单核细胞中稀释1至10个CEA阳性细胞。55例癌症患者中有20例检测呈阳性（36%）。22例对照样本均为阴性。随着疾病分期增加，阳性率升高；然而，即使是一些早期癌症患者也呈阳性结果。此外，13例术前外周血CEA mRNA为阴性的患者中，有3例在手术期间外周血中可检测到CEA mRNA。这些发现表明，（1）CEA mRNA的RT-PCR扩增是检测外周血中循环实体癌细胞的有效方法，尽管需要进行长期临床研究以评估其效用；（2）不仅乳腺癌，胃肠道癌即使在癌症早期也可能更好地被视为全身性疾病；（3）手术操作可引发癌细胞播散。
