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. 2001 Feb;233(2):189-94.
doi: 10.1097/00000658-200102000-00007.

Surgical maneuvers enhance molecular detection of circulating tumor cells during gastric cancer surgery

F Miyazono  1 , S Natsugoe, S Takao, K Tokuda, F Kijima, K Aridome, S Hokita, M Baba, Y Eizuru, T Aikou
Affiliations

Surgical maneuvers enhance molecular detection of circulating tumor cells during gastric cancer surgery

F Miyazono et al. Ann Surg. 2001 Feb.

Abstract

Objective: To evaluate the relation between the presence of cancer cells in blood according to the time course during a surgical procedure and liver metastases in patients with gastric cancer.

Summary background data: Several studies have reported on the detection of circulating cancer cells in blood by reverse transcriptase-polymerase chain reaction (RT-PCR). However, few reports have examined the relation between molecular detection of circulating cancer cells according to the time course during a surgical procedure and blood-borne metastases.

Methods: Blood samples from 57 patients with gastric cancer were obtained from the portal vein, peripheral artery, and superior vena cava before and after tumor dissection. After total RNA was extracted from each blood sample, carcinoembryonic antigen (CEA)-specific RT-PCR was performed.

Results: CEA-mRNA was detected in the blood of 21 (36.8%) of the 57 patients. CEA-mRNA was not detected in the blood obtained from 15 healthy volunteers and 15 patients with benign disease. The positive rate increased in proportion to the depth of tumor. The incidence of positive CEA-mRNA did not differ among the various sites of blood sampling. The appearance of circulating cancer cells was related to the surgical maneuver. A significant relation was found between the detection of CEA-mRNA and blood-borne metastases.

Conclusions: A high incidence of positive CEA-mRNA was found in the blood during gastric cancer surgery. Surgical maneuvers are a possible cause of hematogenous metastasis. The authors found that patients with positive CEA-mRNA had a high risk of blood-borne metastasis even after curative resection.

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Figures

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Figure 1. Expression of carcinoembryonic antigen (CEA)-mRNA. CEA-mRNA was positive in the sample from the superior vena cava before (B) and after (A) resection in patient 1. It was positive in the portal vein after resection in patient 2.
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Figure 2. Positive rate of carcinoembryonic antigen (CEA)-mRNA based on tumor depth and clinical stage.
See this image and copyright information in PMC

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