Spread of colorectal cancer micrometastases in regional lymph nodes by reverse transcriptase-polymerase chain reactions for carcinoembryonic antigen and cytokeratin 20

✍ Scribed by Futamura, Manabu; Takagi, Yukihiro; Koumura, Hisashi; Kida, Hisashi; Tanemura, Hiromi; Shimokawa, Kuniyasu; Saji, Shigetoyo

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 623 KB
• Volume: 68
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199805)68:1<34::aid-jso8>3.0.co;2-m

✦ Synopsis

Background and objectives:

Lymph node metastasis is known as a significant predictor of prognosis in colorectal cancer patients. recently, reverse transcriptase polymerase chain reaction (rt-pcr) has been applied to detecting micrometastasis. to assess the risk of recurrence and accurately determine the spread of tumor cells, we examined lymph node micrometastases in a series of colorectal cancer patients.

Methods:

We examined 202 lymph nodes obtained from 13 colorectal cancer patients who underwent curative operation and were histologically diagnosed to be node-negative, using rt-pcr to amplify mrnas for two epithelial markers, carcinoembryonic antigen (cea) and cytokeratin 20 (ck-20).

Results:

All the cases, including early stage patients, had micrometastases. a total of 102 among 202 lymph nodes (50.5%) were positive for either cea or ck-20, or both (47.0, 40.1, and 36.6% respectively). positive lymph nodes were spread along the courses of vascular trunks as well as being located in more distant regions.

Conclusions:

Even in histologically negative lymph nodes, there is a considerable possibility that micrometastases may exist. their detection by rt-pcr may improve clinical staging and indications for cancer therapy. we should also take care in the choice of surgical approach.