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CEA-Antigen and SCC-Antigen mRNA Expression in Peripheral Blood Predict Hematogenous Recurrence After Resection in Patients with Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although several studies have suggested an association between circulating tumor cells (CTC) and prognosis after esophageal cancer surgery, large-scale studies are lacking. The aim of this study was to prospectively examine the correlation between CTC and outcome in a large number of patients who underwent esophagectomy.

Materials and Methods

A cohort of 244 patients with squamous cell carcinoma of the esophagus who underwent curative surgery between 2002 and 2007 were prospectively analyzed for CTC before surgery and after the thoracic procedure. Reverse transcription-polymerase chain reaction for CEA and SCC antigen mRNA was used to detect cancer cells in the peripheral blood. CTC was defined as positive when at least 1 tumor marker mRNA was detected.

Results

CTC was positive in 34 patients (13.9%) before surgery and in 41 patients (16.8%) after the thoracic procedure. Multivariate analysis identified tumor depth (hazard ratio [HR], 0.439; 95% confidence interval [95% CI], 0.268–0.722; P = 0.0012), lymph node metastasis (HR, 2.467; 95% CI, 1.436–4.237; P = 0.0011), venous invasion (HR, 1.802; 95% CI, 1.082–3.002; P = 0.0236), and CTC status after the thoracic procedure (HR, 1.647; 95% CI, 1.032–2.629; P = 0.0365) as independent prognostic factors of disease-free survival. The rates of hematogenous (P = 0.0222) and local (P = 0.0464) recurrences were significantly higher in patients with CTC(+) after the thoracic procedure than those with CTC(−) after the thoracic procedure. Responders to neoadjuvant chemotherapy showed less lymphatic invasion and a decreased positive CTC rate after the thoracic procedure than nonresponders.

Conclusions

CTC status after the thoracic procedure is a useful predictor for hematogenous and local recurrences in patients with esophageal cancer.

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References

  1. Liu Z, Jiang M, Zhao J, Ju H. Circulating tumor cells in perioperative esophageal cancer patients: quantitative assay system and potential clinical utility. Clin Cancer Res. 2007;13:2992–7.

    Article  CAS  PubMed  Google Scholar 

  2. Setoyama T, Natsugoe S, Okumura H, et al. Carcinoembryonic antigen messenger RNA expression in blood predicts recurrence in esophageal cancer. Clin Cancer Res. 2006;12:5972–7.

    Article  CAS  PubMed  Google Scholar 

  3. Spence GM, Graham AN, Mulholland K, et al. Bone marrow micrometastases and markers of angiogenesis in esophageal cancer. Ann Thorac Surg. 2004;78:1944–9; discussion 1950.

    Article  PubMed  Google Scholar 

  4. Nakamura T, Matsunami K, Hayashi K, et al. Detection of bone marrow micrometastasis in esophageal cancer patients by immunomagnetic separation. Oncol Rep. 2004;11:999–1003.

    PubMed  Google Scholar 

  5. Inoue H, Kajiyama Y, Tsurumaru M. Clinical significance of bone marrow micrometastases in esophageal cancer. Dis Esophagus. 2004;17:328–32.

    Article  CAS  PubMed  Google Scholar 

  6. Noguchi T, Shibata T, Fumoto S, et al. Detection of disseminated cancer cells in rib marrow of patients with esophageal cancer. Oncol Rep. 2003;10:623–7.

    PubMed  Google Scholar 

  7. Patel H, Le Marer N, Wharton RQ, et al. Clearance of circulating tumor cells after excision of primary colorectal cancer. Ann Surg. 2002;235:226–31.

    Article  PubMed  Google Scholar 

  8. Bessa X, Pinol V, Castellvi-Bel S, et al. Prognostic value of postoperative detection of blood circulating tumor cells in patients with colorectal cancer operated on for cure. Ann Surg. 2003;237:368–75.

    Article  PubMed  Google Scholar 

  9. Partridge M, Brakenhoff R, Phillips E, et al. Detection of rare disseminated tumor cells identifies head and neck cancer patients at risk of treatment failure. Clin Cancer Res. 2003;9:5287–94.

    CAS  PubMed  Google Scholar 

  10. Yasuda T, Kabuto T, Ishiguro S, et al. Preoperative neoadjuvant chemotherapy with a combination of 5-fluorouracil, adriamycin and cisplatin (FAP) for advanced esophageal cancer invading trachea or main bronchus. Gan To Kagaku Ryoho. 1995;22:1538–41.

    CAS  PubMed  Google Scholar 

  11. Iizuka T, Onoda T. TNM classification of carcinoma of the esophagus. Gan To Kagaku Ryoho. 1997;24:893–901.

    CAS  PubMed  Google Scholar 

  12. Fabisiewicz A, Kulik J, Kober P, et al. Detection of circulating breast cancer cells in peripheral blood by a two-marker reverse transcriptase-polymerase chain reaction assay. Acta Biochim Pol. 2004;51:747–55.

    CAS  PubMed  Google Scholar 

  13. Nakashima S, Natsugoe S, Matsumoto M, et al. Clinical significance of circulating tumor cells in blood by molecular detection and tumor markers in esophageal cancer. Surgery. 2003;133:162–9.

    Article  PubMed  Google Scholar 

  14. Kaganoi J, Shimada Y, Kano M, et al. Detection of circulating oesophageal squamous cancer cells in peripheral blood and its impact on prognosis. Br J Surg. 2004;91:1055–60.

    Article  CAS  PubMed  Google Scholar 

  15. Hashimoto T, Kajiyama Y, Tsutsumi-Ishii Y, et al. Circulating micrometastases of esophageal cancer detected by carcinoembryonic antigen mRNA reverse transcriptase-polymerase chain reaction: clinical implications. Dis Esophagus. 2008;21:690–6.

    Article  CAS  PubMed  Google Scholar 

  16. Miyazono F, Natsugoe S, Takao S, et al. Surgical maneuvers enhance molecular detection of circulating tumor cells during gastric cancer surgery. Ann Surg. 2001;233:189–94.

    Article  CAS  PubMed  Google Scholar 

  17. Weitz J, Koch M, Kienle P, et al. Detection of hematogenic tumor cell dissemination in patients undergoing resection of liver metastases of colorectal cancer. Ann Surg. 2000;232:66–72.

    Article  CAS  PubMed  Google Scholar 

  18. Fidler IJ. The pathogenesis of cancer metastasis: the “seed and soil” hypothesis revisited. Nat Rev Cancer. 2003;3:453–8.

    Article  CAS  PubMed  Google Scholar 

  19. Hayashi N, Egami H, Kai M, et al. No-touch isolation technique reduces intraoperative shedding of tumor cells into the portal vein during resection of colorectal cancer. Surgery. 1999;125:369–74.

    CAS  PubMed  Google Scholar 

  20. Kurusu Y, Yamashita J, Hayashi N, Mita S, Fujino N, Ogawa M. The sequence of vessel ligation affects tumor release into the circulation. J Thorac Cardiovasc Surg. 1998;116:107–13.

    Article  CAS  PubMed  Google Scholar 

  21. Honma H, Kanda T, Ito H, et al. Squamous cell carcinoma-antigen messenger RNA level in peripheral blood predicts recurrence after resection in patients with esophageal squamous cell carcinoma. Surgery. 2006;139:678–85.

    Article  PubMed  Google Scholar 

  22. Ito H, Kanda T, Nishimaki T, et al. Detection and quantification of circulating tumor cells in patients with esophageal cancer by real-time polymerase chain reaction. J Exp Clin Cancer Res. 2004;23:455–64.

    CAS  PubMed  Google Scholar 

  23. Koike M, Hibi K, Kasai Y, et al. Molecular detection of circulating esophageal squamous cell cancer cells in the peripheral blood. Clin Cancer Res. 2002;8:2879–82.

    CAS  PubMed  Google Scholar 

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Correspondence to Masahiko Yano MD.

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Tanaka, K., Yano, M., Motoori, M. et al. CEA-Antigen and SCC-Antigen mRNA Expression in Peripheral Blood Predict Hematogenous Recurrence After Resection in Patients with Esophageal Cancer. Ann Surg Oncol 17, 2779–2786 (2010). https://doi.org/10.1245/s10434-010-1075-3

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  • DOI: https://doi.org/10.1245/s10434-010-1075-3

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